Active NPI
Jennifer Lynn Lee, PHD
- Psychologist
- Atlanta, GA
National Provider Identifier
1174076269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSYC004025
- Practice address
- 1405 Clifton Rd NE
Psychology Suite - 4TH Floor
Atlanta, GA 30322-1060 - Phone
- (404) 785-3543
- Fax
- (404) 785-6020
- NPI assigned
- Jul 26, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSYC004025 | GA | Primary |
Addresses
Primary practice location
1405 Clifton Rd NE
Psychology Suite - 4TH Floor
Atlanta, GA 30322-1060
Mailing address
1405 Clifton Rd NE
Psychology Suite - 4TH Floor
Atlanta, GA 30322-1060
Phone (404) 785-3543
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSYC004025 | GA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469491200000",
"number": "1174076269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 CLIFTON RD NE",
"address_2": "PSYCHOLOGY SUITE - 4TH FLOOR",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221060",
"telephone_number": "404-785-3543",
"fax_number": "404-785-6020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 CLIFTON RD NE",
"address_2": "PSYCHOLOGY SUITE - 4TH FLOOR",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221060",
"telephone_number": "404-785-3543",
"fax_number": "404-785-6020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-26",
"last_updated": "2016-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "GA",
"license": "PSYC004025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.