Provider Demographics
NPI:1942872544
Name:LEE, DONG EUN (LMFT)
Entity type:Individual
Prefix:
First Name:DONG EUN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13200 CROSSROADS PKWY N BLDG 300
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91746-3459
Mailing Address - Country:US
Mailing Address - Phone:562-821-1491
Mailing Address - Fax:562-362-3137
Practice Address - Street 1:13200 CROSSROADS PKWY N STE 335
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91746-3485
Practice Address - Country:US
Practice Address - Phone:562-821-1491
Practice Address - Fax:562-362-3137
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA150360106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist