Provider Demographics
NPI:1083706188
Name:WEST, LEE THOMAS (LPC)
Entity Type:Individual
Prefix:MR
First Name:LEE
Middle Name:THOMAS
Last Name:WEST
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 WOLF LN
Mailing Address - Street 2:
Mailing Address - City:VALLEY MILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76689-2839
Mailing Address - Country:US
Mailing Address - Phone:254-934-2108
Mailing Address - Fax:254-934-2108
Practice Address - Street 1:2935 WOLF LN
Practice Address - Street 2:
Practice Address - City:VALLEY MILLS
Practice Address - State:TX
Practice Address - Zip Code:76689-2839
Practice Address - Country:US
Practice Address - Phone:254-934-2108
Practice Address - Fax:254-934-2108
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14958101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional