Provider Demographics
NPI:1114075546
Name:MARLEY, LEE FOX (LCSW)
Entity type:Individual
Prefix:MS
First Name:LEE
Middle Name:FOX
Last Name:MARLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 E WHITE AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ARANSAS
Mailing Address - State:TX
Mailing Address - Zip Code:78373-5357
Mailing Address - Country:US
Mailing Address - Phone:512-913-1984
Mailing Address - Fax:
Practice Address - Street 1:230 E WHITE AVE
Practice Address - Street 2:
Practice Address - City:PORT ARANSAS
Practice Address - State:TX
Practice Address - Zip Code:78373-5357
Practice Address - Country:US
Practice Address - Phone:512-913-1984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX051941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX561LMedicaid
TX1041CO700XOtherBCBS OF TEXAS, AETNA, UNITEDHEALTHCARE, SUPERIORHEALTH, AMBETTER,