Provider Demographics
NPI:1275041535
Name:WEST BEY, BRANDY M
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:M
Last Name:WEST BEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 ARSENAL ST STE 505
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-2262
Mailing Address - Country:US
Mailing Address - Phone:315-489-4805
Mailing Address - Fax:877-831-4232
Practice Address - Street 1:1116 ARSENAL ST STE 505
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-2262
Practice Address - Country:US
Practice Address - Phone:315-489-4805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-19
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4514106H00000X
VA0717001964106H00000X
NY001827106H00000X
HI695106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY86-2629734OtherTAX ID