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General NPI Number Information
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NPI Number | 1356841902
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Entity Type | Individual
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Provider Name | DEANDRE DEVELLE WEST LMSW
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Gender | Male
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 350 GATEWAY DR
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City | SLIDELL
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State | LA
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Zip | 70461-5589
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Country | US
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Telephone | 985-707-1410
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Fax |
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Provider Business Mailing Address
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Address Line | 58148 PATRICK ST # C
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City | SLIDELL
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State | LA
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Zip | 70460-6028
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Country | US
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Telephone | 985-288-9671
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 15131
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License Number State | LA
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