Individual
MR. JAE MYUNG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1166 S ELMHURST RD, MT PROSPECT, IL 60056-4241
(847) 439-5195
Mailing address
1166 S ELMHURST RD, MT PROSPECT, IL 60056-4241
(847) 439-5195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
178.013659
IL
101YM0800X
Mental Health Counselor
Primary
178.013659
IL
101YP2500X
Professional Counselor
178.013659
IL
171M00000X
Case Manager/Care Coordinator
178.013659
IL
Other
Enumeration date
04/24/2018
Last updated
04/24/2018
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