Provider Demographics
NPI:1902478191
Name:LEE, PA CHEE (APSW)
Entity Type:Individual
Prefix:
First Name:PA CHEE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-3332
Mailing Address - Country:US
Mailing Address - Phone:920-912-8628
Mailing Address - Fax:
Practice Address - Street 1:601 N 5TH ST
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-4624
Practice Address - Country:US
Practice Address - Phone:920-977-3111
Practice Address - Fax:920-482-5662
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI130444-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker