Provider Demographics
NPI:1972936656
Name:LEE, ANDREA (MS,LPC,LAC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MS,LPC,LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1538 LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3553
Mailing Address - Country:US
Mailing Address - Phone:504-896-2345
Mailing Address - Fax:504-896-2240
Practice Address - Street 1:1538 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3553
Practice Address - Country:US
Practice Address - Phone:504-896-2345
Practice Address - Fax:504-896-2240
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1307101YA0400X
LA3991101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health