Provider Demographics
NPI:1649606401
Name:LEE, SAMUEL SHIH-YU (LPC)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:SHIH-YU
Last Name:LEE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 LOTT AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78721-2652
Mailing Address - Country:US
Mailing Address - Phone:512-200-4110
Mailing Address - Fax:
Practice Address - Street 1:906 E 5TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-3861
Practice Address - Country:US
Practice Address - Phone:512-200-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2015-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60364080101Y00000X, 101YM0800X
TXLPC74495101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health