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Jarvis D Lee

Social Worker

Behavioral Health & Social Service Providers

610 Thimble Shoals Blvd # 403, Newport News, VA 23606-2573

PECOS Enrollment

This provider is enrolled in PECOS as JARVIS LEE.

Based on the most recent information from CMS, provider Jarvis D Lee is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1740765437
Provider Type
Individual
Full Name
Lee, Jarvis D
Gender
Male

Sole Proprietor
Yes
Enumeration Date
9/27/2018
Last Updated
4/9/2022

Contact Information

Practice Location

610 Thimble Shoals Blvd # 403, Newport News, VA 23606-2573

(901) 672-2228

Unlisted Fax

Mailing Location

31 Harwood Ave, Hampton, VA 23664-1044

(901) 672-2228

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 0904013363 Virginia

Jarvis D Lee

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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