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NPI Code Detail

MEDICARE: CHARLES WEST

MEDICARE: CHARLES WEST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor3278KS

General Provider Information

NPI Number : 1063075604
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES WEST
Provider Business Mailing Address
First Line : 4419 TRACY AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64110-1829
Country : US
Telephone Number : 630-302-3275
Fax Number :
Provider Business Practice Location Address
First Line : 7923 SANTA FE DR
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66204-3644
Country : US
Telephone Number : 913-521-8497
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2019
Last Update Date : 11/27/2023

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Directions to “ CHARLES WEST ” Practice Location

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