Individual
CYNTHIA BEASLEY LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
19 CHURCH STREET, STATESBORO, GA 30458-4853
(912) 489-7590
Mailing address
19 CHURCH STREET, STATESBORO, GA 30458-4853
(912) 687-0971
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
APC001451
GA
101YP2500X
Professional Counselor
Primary
LPC005560
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1290450
AMERIGROUP
GA
05
—
200221320A
—
GA
01
—
687341
WELLCARE
GA
Enumeration date
01/25/2007
Last updated
06/19/2013
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