Provider Demographics
NPI:1295548857
Name:LEE, KRISTIN (LPC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 PITZ LN
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-1683
Mailing Address - Country:US
Mailing Address - Phone:630-303-7739
Mailing Address - Fax:
Practice Address - Street 1:4300 WEAVER PKWY STE 100A
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3920
Practice Address - Country:US
Practice Address - Phone:630-303-7739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178021072101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional