Provider Demographics
NPI:1447309513
Name:LEE, CARRIE GRAHAM (LCSW)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:GRAHAM
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 1:1200 EL CAMINO REAL
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY, 3RD FLOOR
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-3208
Mailing Address - Country:US
Mailing Address - Phone:650-742-3274
Mailing Address - Fax:650-742-2591
Practice Address - Street 1:1200 EL CAMINO REAL
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY, 3RD FLOOR
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-3208
Practice Address - Country:US
Practice Address - Phone:650-742-3274
Practice Address - Fax:650-742-2591
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 212071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical