Healthcare Provider Details

I. General information

NPI: 1144148545
Provider Name (Legal Business Name): KATELIN ROSE WEST LCSW-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 N NC HWY 41
BEAULAVILLE NC
28518
US

IV. Provider business mailing address

PO BOX 1321
BEULAVILLE NC
28518-1321
US

V. Phone/Fax

Practice location:
  • Phone: 910-298-6207
  • Fax: 910-298-6293
Mailing address:
  • Phone: 910-298-6207
  • Fax: 910-298-6293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023751
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: