Provider Demographics
NPI:1932468949
Name:LEE, MICHELLE M (T-LPCC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:T-LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13336 LODESTONE TRL SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-1089
Mailing Address - Country:US
Mailing Address - Phone:505-274-3200
Mailing Address - Fax:505-323-0036
Practice Address - Street 1:13336 LODESTONE TRL SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-1089
Practice Address - Country:US
Practice Address - Phone:505-274-3200
Practice Address - Fax:505-323-0036
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0077591101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor