Provider Demographics
NPI:1891280038
Name:LEE, BROOKLYNN ELAINE (MSW)
Entity Type:Individual
Prefix:MS
First Name:BROOKLYNN
Middle Name:ELAINE
Last Name:LEE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 BROADWAY APT 5
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12207-2969
Mailing Address - Country:US
Mailing Address - Phone:315-225-2656
Mailing Address - Fax:
Practice Address - Street 1:24 S PARK ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:NY
Practice Address - Zip Code:12816-1223
Practice Address - Country:US
Practice Address - Phone:315-225-2656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker