Provider Demographics
NPI:1114085529
Name:LEE, JUDITH KAY (LCSW, LIMHP)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:KAY
Last Name:LEE
Suffix:
Gender:F
Credentials:LCSW, LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 ABRAHAM ST
Mailing Address - Street 2:
Mailing Address - City:FIRTH
Mailing Address - State:NE
Mailing Address - Zip Code:68358-6242
Mailing Address - Country:US
Mailing Address - Phone:309-351-3599
Mailing Address - Fax:
Practice Address - Street 1:600 E STATE HIGHWAY 260 STE 1
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-4967
Practice Address - Country:US
Practice Address - Phone:480-788-6070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5397104100000X
NE1863104100000X
COCSW.099289311041C0700X
NE22581041C0700X
AZ189381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker