Provider Demographics
NPI:1275110983
Name:WEST, JAMIE (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5965 STIRLING RD #2211
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-7225
Mailing Address - Country:US
Mailing Address - Phone:754-220-3755
Mailing Address - Fax:
Practice Address - Street 1:5965 STIRLING RD #2211
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-7225
Practice Address - Country:US
Practice Address - Phone:754-220-3755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-27
Last Update Date:2021-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717001554106H00000X
FLM3737106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist