Provider Demographics
NPI:1689480964
Name:WEST, SANDRA LEE (LPC, MS, LCDC, CSAC)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:LEE
Last Name:WEST
Suffix:
Gender:F
Credentials:LPC, MS, LCDC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 CROMWELL DR APT 7207
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-3830
Mailing Address - Country:US
Mailing Address - Phone:808-557-5957
Mailing Address - Fax:
Practice Address - Street 1:4700 CROMWELL DR APT 7207
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-3830
Practice Address - Country:US
Practice Address - Phone:808-557-5957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89293101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty