Provider Demographics
NPI:1891711081
Name:LEE, III, THOMAS SMITH (MAED)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:SMITH
Last Name:LEE, III
Suffix:
Gender:M
Credentials:MAED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 REED ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2729
Mailing Address - Country:US
Mailing Address - Phone:828-274-6606
Mailing Address - Fax:
Practice Address - Street 1:31 COLLEGE PL
Practice Address - Street 2:SUITE B-5
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2483
Practice Address - Country:US
Practice Address - Phone:828-254-2887
Practice Address - Fax:828-254-2072
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC936101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6111678Medicaid