Individual
JEREMY NEIL LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., LPC-IT, CSAC
Contact information
Practice address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 252-8283
Mailing address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 252-8283
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15992-132
WI
101YP2500X
Professional Counselor
Primary
2876-226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285094607
—
WI
Enumeration date
02/26/2016
Last updated
02/16/2024
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