Healthcare Provider Details

I. General information

NPI: 1871340943
Provider Name (Legal Business Name): CLARA LEE WEST LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 CLIFF RD
ASHEBORO NC
27203-5804
US

IV. Provider business mailing address

200 E 2ND AVE
GASTONIA NC
28052-4358
US

V. Phone/Fax

Practice location:
  • Phone: 336-625-6226
  • Fax:
Mailing address:
  • Phone: 704-874-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberP020538
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: