Provider Demographics
NPI:1689469496
Name:WEST, RICKEY DAVION
Entity type:Individual
Prefix:
First Name:RICKEY
Middle Name:DAVION
Last Name:WEST
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 ESTATES BLVD APT 37
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-2111
Mailing Address - Country:US
Mailing Address - Phone:609-554-4275
Mailing Address - Fax:
Practice Address - Street 1:174 ESTATES BLVD APT 37174
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-2111
Practice Address - Country:US
Practice Address - Phone:609-554-4275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJW28256566404052251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management