MEDICARE: KC 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
1	1041C0700X	Clinical Social Worker	6894-C	NV

General Provider Information

NPI Number	:	1376945758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KC WEST

Provider Business Mailing Address
First Line	:	3161 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3144
Country	:	US
Telephone Number	:	435-749-0093
Fax Number	:	844-965-9650

Provider Business Practice Location Address
First Line	:	3161 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3144
Country	:	US
Telephone Number	:	702-467-7256
Fax Number	:	844-965-9650

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2014
Last Update Date	:	12/07/2021

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Directions to “ KC WEST ” Practice Location

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