Provider Demographics
NPI:1205484227
Name:OH-LEE, JUSTIN D (LMSW)
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:D
Last Name:OH-LEE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 NB GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-2301
Mailing Address - Country:US
Mailing Address - Phone:586-783-2950
Mailing Address - Fax:586-690-4333
Practice Address - Street 1:5816 EASTMAN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6792
Practice Address - Country:US
Practice Address - Phone:989-244-1888
Practice Address - Fax:989-321-6544
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011056601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical