Provider Demographics
NPI:1043269749
Name:LEE, AMELIA E (LCSW)
Entity type:Individual
Prefix:MS
First Name:AMELIA
Middle Name:E
Last Name:LEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 540231
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33454-0231
Mailing Address - Country:US
Mailing Address - Phone:561-308-4432
Mailing Address - Fax:561-963-4481
Practice Address - Street 1:1499 FOREST HILL BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6050
Practice Address - Country:US
Practice Address - Phone:561-308-4432
Practice Address - Fax:561-963-4481
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW64691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ084SZMedicare PIN
FLZ084SAMedicare PIN