Healthcare Provider Details

I. General information

NPI: 1043009657
Provider Name (Legal Business Name): KASEY SCOTT WEST LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3113 E TOPEKA DR
PHOENIX AZ
85050-2559
US

IV. Provider business mailing address

3113 E TOPEKA DR
PHOENIX AZ
85050-2559
US

V. Phone/Fax

Practice location:
  • Phone: 602-586-8738
  • Fax:
Mailing address:
  • Phone: 602-586-8738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-23717
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14226136-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: