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Organization

LARRY L LEE, LSCSW

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LARRY LYNN LEE LSCSW (THERAPIST)
(316) 734-5670
Entity
Organization

Contact information

Practice address
1440 TAPESTRY LN, GODDARD, KS 67052-9337
(316) 734-5670
(316) 550-6380
Mailing address
1440 TAPESTRY LN, GODDARD, KS 67052-9337
(316) 734-5670
(316) 550-6380

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2003 LSCSW
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100458440A
KS
01
1255329488
TYPE I NPI 1255329488
KS
Enumeration date
07/26/2011
Last updated
07/26/2011
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