Healthcare Provider Details

I. General information

NPI: 1518136019
Provider Name (Legal Business Name): SABRINA L. WEST, LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2008
Last Update Date: 05/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 APPLE ALY
HARTFORD KY
42347-1101
US

IV. Provider business mailing address

PO BOX 43
HARTFORD KY
42347-0043
US

V. Phone/Fax

Practice location:
  • Phone: 270-298-0088
  • Fax:
Mailing address:
  • Phone: 270-298-0088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberKY-1061
License Number StateKY

VIII. Authorized Official

Name: SABRINA LYNNE WEST
Title or Position: OWNER
Credential: LCSW
Phone: 270-298-0088