Provider Demographics
NPI:1942466875
Name:LEE, SEAN (LCSW-C)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 VIEWRIDGE CT APT F
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-3530
Mailing Address - Country:US
Mailing Address - Phone:410-665-4160
Mailing Address - Fax:
Practice Address - Street 1:3 VIEWRIDGE CT APT F
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-3530
Practice Address - Country:US
Practice Address - Phone:410-665-4160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD124851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical