Provider Demographics
NPI:1861212680
Name:WEST, LEAH (LIA) (MA LPC-MHSP TEMP)
Entity type:Individual
Prefix:
First Name:LEAH (LIA)
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:MA LPC-MHSP TEMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-3614
Mailing Address - Country:US
Mailing Address - Phone:512-740-0110
Mailing Address - Fax:
Practice Address - Street 1:817 WESTCOTT LN
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-5272
Practice Address - Country:US
Practice Address - Phone:512-740-0110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6333101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional