Provider Demographics
NPI:1053177279
Name:LEE, DENA (LPC)
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 DEVON MILL WAY
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168-5923
Mailing Address - Country:US
Mailing Address - Phone:404-740-4852
Mailing Address - Fax:
Practice Address - Street 1:1445 DEVON MILL WAY
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30168-5923
Practice Address - Country:US
Practice Address - Phone:404-470-4852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006742101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor