Provider Demographics
NPI:1942744867
Name:LEE, EUNICE WONJOO (LCSW)
Entity type:Individual
Prefix:
First Name:EUNICE
Middle Name:WONJOO
Last Name:LEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:WON JOO
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:23 HAMPTON CT
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-3098
Mailing Address - Country:US
Mailing Address - Phone:908-373-1079
Mailing Address - Fax:
Practice Address - Street 1:23 HAMPTON CT
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-3098
Practice Address - Country:US
Practice Address - Phone:908-373-1079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-12
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06209400104100000X
NJ44SC059293001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker