Provider Demographics
NPI:1093507386
Name:WEST, LORI D (LPC-A)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:D
Last Name:WEST
Suffix:
Gender:X
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15653 SWEETPINE LN
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-3361
Mailing Address - Country:US
Mailing Address - Phone:817-504-9495
Mailing Address - Fax:
Practice Address - Street 1:381 W BYRON NELSON BLVD STE 201
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262-3517
Practice Address - Country:US
Practice Address - Phone:817-504-9495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX98766101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health