Provider Demographics
NPI:1316190879
Name:WEST, HAZEL G (LCSW)
Entity Type:Individual
Prefix:MS
First Name:HAZEL
Middle Name:G
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 1:560 S STATE ST
Mailing Address - Street 2:SUITE G-1
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-6354
Mailing Address - Country:US
Mailing Address - Phone:801-802-8608
Mailing Address - Fax:801-221-1042
Practice Address - Street 1:560 S STATE ST
Practice Address - Street 2:SUITE G-1
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6354
Practice Address - Country:US
Practice Address - Phone:801-802-8608
Practice Address - Fax:801-221-1042
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6221795-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical