Individual provider Active NPI

Andrew Lee, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Avon, CT
National Provider Identifier
1811651177
Registry record updated Sep 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
9692 Issued in CT
Practice address
135 Waterville Rd
Avon, CT 06001-2041
Phone
(860) 292-0763
NPI assigned
Oct 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 9692 CT Primary

Addresses

Primary practice location

135 Waterville Rd
Avon, CT 06001-2041

Mailing address

135 Waterville Rd
Avon, CT 06001-2041
Phone (860) 292-0763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211202002886 CT Practitioner - Psychiatry 1052701109 Reassigns benefits to 1 organization
I20251208000133 CT Practitioner - Nurse Practitioner 1052701109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Step Up Care PC LLCGroup PAC ID 5496088346, 176 clinicians

Practice addresses (Care Compare)

111 Westcott Rd
Danielson, CT 06239-2929
Phone (718) 298-4375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9692CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intercommunity, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Step Up Care PC LLC CurrentSince Oct 15, 2025 Accepting new patients
Intercommunity, Inc. Current Accepting new patients
Lee Behavioral Health LLC CurrentSince Sep 14, 2025 Accepting new patients

Locations

111 Westcott Rd
Danielson, CT 06239
Phone (860) 774-9540

281 Main St
East Hartford, CT 06118
Phone (860) 291-1335

16 Coventry St
Hartford, CT 06112
Phone (860) 714-3701

800 Connecticut Blvd
Fl 4
Hartford, CT 06108
Phone (860) 622-5451

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Organizations & group practices 4

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": "1634947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757203200000",
    "number": "1811651177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 WATERVILLE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012041",
            "telephone_number": "860-292-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 WATERVILLE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012041",
            "telephone_number": "860-292-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ANDREW",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-23",
        "last_updated": "2025-09-07",
        "certification_date": "2025-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "9692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.