Healthcare Provider Details

I. General information

NPI: 1275110983
Provider Name (Legal Business Name): JAMIE WEST PHD, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2021
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 CHURCH ST NW STE 300D
VIENNA VA
22180-4437
US

IV. Provider business mailing address

243 CHURCH ST NW STE 300D
VIENNA VA
22180-4437
US

V. Phone/Fax

Practice location:
  • Phone: 703-594-7121
  • Fax:
Mailing address:
  • Phone: 703-594-7121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2258
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717001554
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT200001231
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4101007691
License Number StateMI
# 5
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM3737
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: