Provider Demographics
NPI:1174220909
Name:LINDSEY M LEE LLC
Entity type:Organization
Organization Name:LINDSEY M LEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:334-791-5926
Mailing Address - Street 1:21383 BRICK STACK LN
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-6686
Mailing Address - Country:US
Mailing Address - Phone:334-791-5926
Mailing Address - Fax:
Practice Address - Street 1:8390 GAYFER ROAD EXT
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-3050
Practice Address - Country:US
Practice Address - Phone:251-286-5458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health