Provider Demographics
NPI:1245070176
Name:LEE, WON JIN (LPC)
Entity type:Individual
Prefix:DR
First Name:WON
Middle Name:JIN
Last Name:LEE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10306 EATON PL STE 300-A17
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2201
Mailing Address - Country:US
Mailing Address - Phone:703-951-7422
Mailing Address - Fax:
Practice Address - Street 1:10306 EATON PL STE 300-A17
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2201
Practice Address - Country:US
Practice Address - Phone:703-941-7422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013623101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty