Provider Demographics
NPI:1063583508
Name:MYER, LEE SLOHM (LCSW-R)
Entity type:Individual
Prefix:MR
First Name:LEE
Middle Name:SLOHM
Last Name:MYER
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 SCHILDKNECHT RD
Mailing Address - Street 2:
Mailing Address - City:HURLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12443-6024
Mailing Address - Country:US
Mailing Address - Phone:845-338-1879
Mailing Address - Fax:
Practice Address - Street 1:1081 DEVELOPMENT CT
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-1959
Practice Address - Country:US
Practice Address - Phone:845-334-5094
Practice Address - Fax:845-334-5090
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR057775-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical