Provider Demographics
NPI:1700099835
Name:LEE, EUNAH KIM (LPC-S)
Entity type:Individual
Prefix:
First Name:EUNAH
Middle Name:KIM
Last Name:LEE
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4575 WESTGROVE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-6479
Mailing Address - Country:US
Mailing Address - Phone:469-907-5150
Mailing Address - Fax:214-461-0451
Practice Address - Street 1:4575 WESTGROVE DR STE 101
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-6479
Practice Address - Country:US
Practice Address - Phone:469-907-5150
Practice Address - Fax:214-461-0451
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20260101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional