Provider Demographics
NPI:1134726151
Name:LEE, AUTUMN KELSEY (MS LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:KELSEY
Last Name:LEE
Suffix:
Gender:F
Credentials:MS LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 ELM ST APT 7
Mailing Address - Street 2:
Mailing Address - City:LOCKHART
Mailing Address - State:TX
Mailing Address - Zip Code:78644-2359
Mailing Address - Country:US
Mailing Address - Phone:817-903-5993
Mailing Address - Fax:
Practice Address - Street 1:4168 COUNTY ROAD 444
Practice Address - Street 2:
Practice Address - City:WAELDER
Practice Address - State:TX
Practice Address - Zip Code:78959-5328
Practice Address - Country:US
Practice Address - Phone:830-240-1594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92863101YP2500X
TX388912355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant