Provider Demographics
NPI:1912230665
Name:LEE, DANIEL SEUNGCHUL (MSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:SEUNGCHUL
Last Name:LEE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:MR
Other - First Name:SEUNG
Other - Middle Name:CHUL
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:14112 S KINGSLEY DR
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90249-3018
Mailing Address - Country:US
Mailing Address - Phone:310-217-7312
Mailing Address - Fax:310-352-3111
Practice Address - Street 1:14112 S KINGSLEY DR
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90249-3018
Practice Address - Country:US
Practice Address - Phone:310-217-7312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical