Provider Demographics
NPI:1366522732
Name:LEE, EMILY C (LCSW, BCD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:C
Last Name:LEE
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10415 HICKORY PATH WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-0701
Mailing Address - Country:US
Mailing Address - Phone:865-675-1555
Mailing Address - Fax:865-675-2003
Practice Address - Street 1:10415 HICKORY PATH WAY STE 101
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-0701
Practice Address - Country:US
Practice Address - Phone:865-675-1555
Practice Address - Fax:865-675-2003
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLCSW0250104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3694451Medicaid
TN3694451Medicaid