Modesta Lee, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

PRO015447 Issued in NY

Practice address

11 Saxon Ave
Staten Island, NY 10314-4813

Phone

(718) 761-7716

Fax

(718) 477-0079

NPI assigned

Feb 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1669516514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SAXON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144813",
            "telephone_number": "718-761-7716",
            "fax_number": "718-477-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SAXON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144813",
            "telephone_number": "718-761-7716",
            "fax_number": "718-477-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MODESTA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PRO015447",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "SC14940",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01668675",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Lee, NURSE PRACTITIONER
• Man So Lee, MD
• Maryann Lee, M.D.
• Melissa Lee
• Merrie Lee
• Oliver Chin-Tin Lee, MD
• Samantha Maria Lee, MD
• Sandra D Lee, L.C.S.W.
• Sangeun Lee, MSW
• Seung Gwan Lee

• Clinical Social Worker in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.

Verify at the official NPI Registry.