Provider Demographics
NPI:1265993927
Name:WEST, BERTRINA OLIVIA
Entity type:Individual
Prefix:DR
First Name:BERTRINA
Middle Name:OLIVIA
Last Name:WEST
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:OLIVIA
Other - Middle Name:
Other - Last Name:AL-MAHDI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:3470 MCCLURE BRIDGE RD UNIT 621
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1105
Mailing Address - Country:US
Mailing Address - Phone:404-900-9583
Mailing Address - Fax:
Practice Address - Street 1:4720 PEACHTREE INDUSTRIAL BLVD STE 4201
Practice Address - Street 2:
Practice Address - City:BERKELEY LAKE
Practice Address - State:GA
Practice Address - Zip Code:30071-5738
Practice Address - Country:US
Practice Address - Phone:404-900-9583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA101YM0800X, 101YP2500X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist