Provider Demographics
NPI:1376653493
Name:LEES, PATRICIA (PHD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:LEES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 FOREST CT
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5078
Mailing Address - Country:US
Mailing Address - Phone:865-558-8669
Mailing Address - Fax:865-558-8648
Practice Address - Street 1:105 FOREST CT
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5078
Practice Address - Country:US
Practice Address - Phone:865-558-8669
Practice Address - Fax:865-558-8648
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000001512103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3685303Medicaid
TN0125281OtherBLUE CROSS BLUE SHIELD NU
TN3685303Medicare ID - Type UnspecifiedMEDICARE ID NUMBER