Provider Demographics
NPI:1205301660
Name:LEE, ESSENCE D (MA,LCPC)
Entity type:Individual
Prefix:
First Name:ESSENCE
Middle Name:D
Last Name:LEE
Suffix:
Gender:F
Credentials:MA,LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 WESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-2170
Mailing Address - Country:US
Mailing Address - Phone:217-201-1736
Mailing Address - Fax:
Practice Address - Street 1:2316 WESTVIEW DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-2170
Practice Address - Country:US
Practice Address - Phone:217-201-1736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional