Provider Demographics
NPI:1932423670
Name:CHASEN, LEE R (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:R
Last Name:CHASEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 LITTLE EAST NECK RD S
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-3208
Mailing Address - Country:US
Mailing Address - Phone:631-321-6675
Mailing Address - Fax:
Practice Address - Street 1:34 LITTLE EAST NECK RD S
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-3208
Practice Address - Country:US
Practice Address - Phone:631-321-6675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0004831101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health