Provider Demographics
NPI:1154622439
Name:LEE, SHUI LIN (LMSW)
Entity type:Individual
Prefix:MS
First Name:SHUI
Middle Name:LIN
Last Name:LEE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 GOLD ST
Mailing Address - Street 2:APT. 8F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1834
Mailing Address - Country:US
Mailing Address - Phone:212-406-6039
Mailing Address - Fax:212-406-6039
Practice Address - Street 1:69 GOLD ST
Practice Address - Street 2:APT. 8F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1834
Practice Address - Country:US
Practice Address - Phone:212-406-6039
Practice Address - Fax:212-406-6039
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052782104100000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY885886010OtherLEARNER PERMIT