Provider Demographics
NPI:1548670375
Name:LEE, BETH (LISW- S)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LISW- S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 NW WASHINGTON BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-5834
Mailing Address - Country:US
Mailing Address - Phone:513-869-7000
Mailing Address - Fax:513-785-4272
Practice Address - Street 1:2201 NW WASHINGTON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-5834
Practice Address - Country:US
Practice Address - Phone:513-869-7000
Practice Address - Fax:513-785-4272
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00027751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical