Individual provider Active NPI

Jean M. Lee, D.MIN.

  • Professional Counselor
  • Show Low, AZ
National Provider Identifier
1033214309
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC10443 Issued in AZ
Practice address
1141 E. Cooley St.,
Ste O
Show Low, AZ 85901
Phone
(928) 532-3238
Fax
(928) 532-3292
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LISAC10187 AZ
Mental Health Counselor 101YM0800X LPC10443 AZ
Professional Counselor 101YP2500X LPC-10443 AZ
Professional Counselor 101YP2500X LPC10443 AZ Primary

Addresses

Primary practice location

1141 E. Cooley St.,
Ste O
Show Low, AZ 85901

Mailing address

PO Box 3872
Show Low, AZ 85902
Phone (928) 532-3238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LISAC10187AZMDAddiction (Substance Use Disorder) Counselor
LPC-10443AZMDProfessional Counselor
LPC10443AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gabriel Outreach Inc CurrentSince Jan 26, 2022 Accepting new patients
White Mountain Counseling Past Accepting new patients

Locations

1141 E Cooley St
Show Low, AZ 85901
Phone (928) 532-3238

1141 E Cooley St
Ste O
Show Low, AZ 85901
Phone (928) 532-3238

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1033214309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3872",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "85902",
            "telephone_number": "928-532-3238",
            "fax_number": "928-532-3292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 E. COOLEY ST.,",
            "address_2": "STE O",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "85901",
            "telephone_number": "928-532-3238",
            "fax_number": "928-532-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JEAN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.MIN.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC10187",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC10443",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-10443",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC10443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.