Provider Demographics
NPI:1871744383
Name:ALBAN, LEE A (LPC)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:A
Last Name:ALBAN
Suffix:
Gender:M
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:PO BOX 118
Mailing Address - Street 2:255 W MAIN STREET
Mailing Address - City:ST. CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-1040
Mailing Address - Country:US
Mailing Address - Phone:740-695-9447
Mailing Address - Fax:740-695-8895
Practice Address - Street 1:255 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-1040
Practice Address - Country:US
Practice Address - Phone:740-695-9447
Practice Address - Fax:740-695-8895
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH041002101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH24-01Medicaid
OH24-01Medicaid