Provider Demographics
NPI:1396405072
Name:LEE, TAWANA MICHELLE (MSW, LICSW, LMSW)
Entity type:Individual
Prefix:
First Name:TAWANA
Middle Name:MICHELLE
Last Name:LEE
Suffix:
Gender:F
Credentials:MSW, LICSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4518 BEECH RD STE 230
Mailing Address - Street 2:
Mailing Address - City:MARLOW HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-6735
Mailing Address - Country:US
Mailing Address - Phone:240-814-8519
Mailing Address - Fax:
Practice Address - Street 1:4518 BEECH RD STE 230
Practice Address - Street 2:
Practice Address - City:MARLOW HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20748-6735
Practice Address - Country:US
Practice Address - Phone:240-814-8519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-22
Last Update Date:2025-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG500817891041C0700X
DCLC2000033331041C0700X
MD307271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical