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General NPI Number Information
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NPI Number | 1093507386
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Entity Type | Individual
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Provider Name | LORI D WEST LPC-A
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Gender |
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Dates
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Enumeration Date | 05/21/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 381 W BYRON NELSON BLVD STE 201
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City | ROANOKE
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State | TX
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Zip | 76262-3517
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Country | US
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Telephone | 817-504-9495
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Fax |
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Provider Business Mailing Address
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Address Line | 15653 SWEETPINE LN
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City | ROANOKE
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State | TX
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Zip | 76262-3361
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Country | US
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Telephone | 817-504-9495
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 98766
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License Number State | TX
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