| Larry L Lee, Lscsw | |
|
1440 Tapestry Ln Goddard KS 67052-9337 | |
| (316) 734-5670 | |
| (316) 550-6380 |
| Full Name | Larry L Lee, Lscsw |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1440 Tapestry Ln, Goddard, Kansas |
| Authorized Official Name and Position | Larry Lynn Lee (THERAPIST) |
| Authorized Official Contact | 3167345670 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Larry L Lee, Lscsw 1440 Tapestry Ln Goddard KS 67052-9337 Ph: (316) 734-5670 | Larry L Lee, Lscsw 1440 Tapestry Ln Goddard KS 67052-9337 Ph: (316) 734-5670 |
| NPI Number | 1568740413 |
|---|---|
| Provider Enumeration Date | 07/26/2011 |
| Last Update Date | 07/26/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568740413 | NPI | - | NPPES |
| 100458440A | Medicaid | KS | |
| 1255329488 | Other | KS | TYPE I NPI 1255329488 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2003 LSCSW (Kansas) | Primary |
Lakeside Academy Of Kansas Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 24401 W Macarthur Rd, Goddard, KS 67052 Phone: 316-794-2760 Fax: 316-794-2773 | |
Lakeside Academy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 24401 W Macarthur Rd, Goddard, KS 67052 Phone: 316-794-2760 |