Michelle Jung Ah Lee, LICSW, SUDP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61601450 Issued in WA

Practice address

12550 120TH Ave NE Unit 668
Kirkland, WA 98034-7559

Phone

(425) 747-7892

NPI assigned

Mar 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Practice roles

Locations

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.

• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678
  NPD

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736553600000",
    "number": "1962905661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19726 50TH AVE W APT 102",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 120TH AVE NE UNIT 668",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347559",
            "telephone_number": "425-747-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MICHELLE",
        "middle_name": "JUNG AH",
        "credential": "LICSW, SUDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-09",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61309243",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61601450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krisitn Kay Lee
• Laura Lee, LMP
• Linda Lee, DO
• Melissa Diianni Lee, M.D.
• Mi-Jung Lee, N.D.,LAC
• Scott William Lee, PH.D.
• Sheila Sung Lee, PHD
• Yung Jae Lee, D.O.
• Brian Lefavour, OTR/L
• Allison Kathryn Lehman

• Clinical Social Worker in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2025; 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.