Provider Demographics
NPI:1033530431
Name:WEST, LINDY (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:LINDY
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 STATE ST
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-5315
Mailing Address - Country:US
Mailing Address - Phone:337-246-7525
Mailing Address - Fax:866-616-5821
Practice Address - Street 1:611 STATE ST
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-5315
Practice Address - Country:US
Practice Address - Phone:337-246-7525
Practice Address - Fax:866-616-5821
Is Sole Proprietor?:No
Enumeration Date:2014-01-02
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-13-14358103K00000X
LAL-028103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2359771Medicaid