Provider Demographics
NPI:1053321398
Name:WEST, SABRINA LYNNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:LYNNE
Last Name:WEST
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:KY
Mailing Address - Zip Code:42347
Mailing Address - Country:US
Mailing Address - Phone:270-298-0088
Mailing Address - Fax:270-298-0001
Practice Address - Street 1:121 APPLE ALLEY
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:KY
Practice Address - Zip Code:42347
Practice Address - Country:US
Practice Address - Phone:270-298-0088
Practice Address - Fax:270-298-0001
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S36686Medicare UPIN
KY9088Medicare ID - Type Unspecified