Provider Demographics
NPI:1265787865
Name:LEE, SUE-JUNG (MS ED)
Entity type:Individual
Prefix:MRS
First Name:SUE-JUNG
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:SUE-JUNG
Other - Middle Name:
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 OLD PALISADE RD APT 3C
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-7057
Mailing Address - Country:US
Mailing Address - Phone:201-614-3560
Mailing Address - Fax:
Practice Address - Street 1:200 OLD PALISADE RD APT 3C
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-7057
Practice Address - Country:US
Practice Address - Phone:201-614-3560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00608800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health