Provider Demographics
NPI:1124026794
Name:LEE, SUSAN JOYE (LPC-MHSP, RPT, SUP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:JOYE
Last Name:LEE
Suffix:
Gender:F
Credentials:LPC-MHSP, RPT, SUP
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:JOYE
Other - Last Name:BIEDERSTADT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9247 SPEERBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-2399
Mailing Address - Country:US
Mailing Address - Phone:901-251-4457
Mailing Address - Fax:
Practice Address - Street 1:6510 STAGE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-3892
Practice Address - Country:US
Practice Address - Phone:901-488-3123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14555101Y00000X
TN2128101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN11737193OtherCAQH
TN4154354OtherBCBS OF TN
TN10043951OtherAMERICAN BEHAVIORAL
TX84528LOtherBCBS