Provider Demographics
NPI:1255194569
Name:JEE, NATHAN (MA, LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:JEE
Suffix:
Gender:M
Credentials:MA, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 LICORICE LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-3617
Mailing Address - Country:US
Mailing Address - Phone:214-695-8458
Mailing Address - Fax:
Practice Address - Street 1:7000 N MOPAC EXPY STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3013
Practice Address - Country:US
Practice Address - Phone:214-695-8458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94642101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health