Provider Demographics
NPI:1487906236
Name:LEE, SHIELA E (MED, NCC, LPC)
Entity type:Individual
Prefix:
First Name:SHIELA
Middle Name:E
Last Name:LEE
Suffix:
Gender:F
Credentials:MED, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-9654
Mailing Address - Country:US
Mailing Address - Phone:252-320-3130
Mailing Address - Fax:252-355-0499
Practice Address - Street 1:1512 N GREENE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-1221
Practice Address - Country:US
Practice Address - Phone:252-689-6006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3385101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional