Provider Demographics
NPI:1154986818
Name:LEA, LYNZEE (MSW, CSW-INTERN)
Entity type:Individual
Prefix:
First Name:LYNZEE
Middle Name:
Last Name:LEA
Suffix:
Gender:F
Credentials:MSW, CSW-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 S GREEN VALLEY PKWY APT 824
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-2979
Mailing Address - Country:US
Mailing Address - Phone:256-508-7807
Mailing Address - Fax:
Practice Address - Street 1:2255 RENAISSANCE DR STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6194
Practice Address - Country:US
Practice Address - Phone:702-471-0420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical