Provider Demographics
NPI:1912967530
Name:LEE, DEBORAH DENISE (MSW, LCSW, LCAS)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:DENISE
Last Name:LEE
Suffix:
Gender:F
Credentials:MSW, LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 955
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-0955
Mailing Address - Country:US
Mailing Address - Phone:704-640-2870
Mailing Address - Fax:
Practice Address - Street 1:850 JAKE ALEXANDER BLVD W # 248
Practice Address - Street 2:SUITE G
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-1225
Practice Address - Country:US
Practice Address - Phone:704-640-2870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2012-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0051991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007745Medicaid