Provider Demographics
NPI:1750190948
Name:LEE, YOO JEONG
Entity type:Individual
Prefix:
First Name:YOO JEONG
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:400 CENTRAL PARK W APT 2G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5823
Mailing Address - Country:US
Mailing Address - Phone:917-753-6344
Mailing Address - Fax:
Practice Address - Street 1:400 CENTRAL PARK W APT 2G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5823
Practice Address - Country:US
Practice Address - Phone:917-753-6344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health