Provider Demographics
NPI:1548457773
Name:LEE, GERALD EUGENE (LPC)
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:EUGENE
Last Name:LEE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 S LOOP W STE 415
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2769
Mailing Address - Country:US
Mailing Address - Phone:713-664-6777
Mailing Address - Fax:713-664-6888
Practice Address - Street 1:2616 S LOOP W STE 415
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2769
Practice Address - Country:US
Practice Address - Phone:713-664-6777
Practice Address - Fax:713-664-6888
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15331101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional