Provider Demographics
NPI:1669159240
Name:LEE, ANNA ISABEL (LCSW)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:ISABEL
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 1:647 TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-3227
Mailing Address - Country:US
Mailing Address - Phone:860-984-6262
Mailing Address - Fax:
Practice Address - Street 1:677 S MAIN ST STE 5A
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-3161
Practice Address - Country:US
Practice Address - Phone:860-984-6262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT131571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical