John Won Lee, PH.D., M.A., M.B.A.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS01119 Issued in RI

Practice address

124 Waterman St
Providence, RI 02906-2052

Phone

(401) 632-0155

Fax

(401) 632-0570

NPI assigned

Jun 3, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Master of Business Administration, Doctor of Philosophy

State licenses

Practice roles

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.

• Coastal Medical Inc

  • Internal Medicine Physician
  • Providence, RI
  • NPI 1609863828
  NPD (past)
• East Side Orthopaedics, Inc

  • Pediatric Orthopaedic Surgery Physician
  • Providence, RI
  • NPI 1861605354
  NPD (past)

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243987200000",
    "number": "1962638007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 WATERMAN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062052",
            "telephone_number": "401-632-0155",
            "fax_number": "401-632-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 WATERMAN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062052",
            "telephone_number": "401-632-0155",
            "fax_number": "401-632-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JOHN",
        "middle_name": "WON",
        "name_prefix": "Dr.",
        "credential": "PH.D., M.A., M.B.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-03",
        "last_updated": "2009-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS01119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felix Lee, MD
• Grace Lee
• Jerin Lee, PHD
• Jisoo Lee, M.D.
• John Lee, M.D.
• Lawrence W Lee, M.D.
• Noelle L. Lee, DO
• Peter D Lee, LICSW
• Ryan S Lee, DDS, MPH
• Sharon Lee, PHD

• Clinical Psychologist in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Psychologist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; 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.