Provider Demographics
NPI:1457996159
Name:LEE, HEE NYOUNG (LCSW)
Entity Type:Individual
Prefix:
First Name:HEE
Middle Name:NYOUNG
Last Name:LEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 BUSHWICK ST
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-1201
Mailing Address - Country:US
Mailing Address - Phone:631-943-4476
Mailing Address - Fax:
Practice Address - Street 1:59 BUSHWICK ST
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-1201
Practice Address - Country:US
Practice Address - Phone:631-943-4476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088887-011041C0700X
NY0888871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical