Provider Demographics
NPI:1902083314
Name:WEST, ANDREA CAMILLE (CAP, LMHC)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:CAMILLE
Last Name:WEST
Suffix:
Gender:F
Credentials:CAP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 LAKEVIEW DR STE 2
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-7959
Mailing Address - Country:US
Mailing Address - Phone:863-207-4788
Mailing Address - Fax:
Practice Address - Street 1:107 MEDICAL CENTER AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-5423
Practice Address - Country:US
Practice Address - Phone:863-382-9280
Practice Address - Fax:863-382-6299
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9206101YM0800X
FLCAP2899101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health