Provider Demographics
NPI:1154132702
Name:LEE, MORRELL DEON SR (MA)
Entity type:Individual
Prefix:
First Name:MORRELL
Middle Name:DEON
Last Name:LEE
Suffix:SR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7862 W IRLO BRONSON MEMORIAL HWY STE 127
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34747-1738
Mailing Address - Country:US
Mailing Address - Phone:407-907-2250
Mailing Address - Fax:
Practice Address - Street 1:205 HATTERAS AVE STE 105
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6502
Practice Address - Country:US
Practice Address - Phone:352-348-8858
Practice Address - Fax:352-708-5603
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24818101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health