Provider Demographics
NPI:1184750960
Name:DUKES, LEE STOLL III (DMIN)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:STOLL
Last Name:DUKES
Suffix:III
Gender:M
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-5548
Mailing Address - Country:US
Mailing Address - Phone:336-249-4576
Mailing Address - Fax:
Practice Address - Street 1:227 N TALBERT BLVD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-4142
Practice Address - Country:US
Practice Address - Phone:336-249-4576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral