Active NPI
Erica Michelle Lynne Lee, LMSW
- Social Worker
- Davenport, IA
National Provider Identifier
1669003398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 077434
- Practice address
- 2800 Eastern Ave
Davenport, IA 52803-2012 - Phone
- (563) 326-8671
- NPI assigned
- Jan 31, 2020
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 077434 | IA | Primary |
Addresses
Primary practice location
2800 Eastern Ave
Davenport, IA 52803-2012
Mailing address
2800 Eastern Ave
Davenport, IA 52803-2012
Phone (563) 326-8671
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
| License | State | Type | Specialty |
|---|---|---|---|
| 077434 | IA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580428800000",
"number": "1669003398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 EASTERN AVE",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528032012",
"telephone_number": "563-326-8671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 EASTERN AVE",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528032012",
"telephone_number": "563-326-8671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "ERICA",
"middle_name": "MICHELLE LYNNE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-31",
"last_updated": "2020-01-31",
"certification_date": "2020-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IA",
"license": "077434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.