Provider Demographics
NPI:1467572735
Name:WEST, GALE JONES (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:GALE
Middle Name:JONES
Last Name:WEST
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2347 E ORANGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4730
Mailing Address - Country:US
Mailing Address - Phone:602-997-7713
Mailing Address - Fax:602-997-2358
Practice Address - Street 1:5251 N 16TH ST
Practice Address - Street 2:SUITE 707
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-3217
Practice Address - Country:US
Practice Address - Phone:602-469-2255
Practice Address - Fax:602-997-2358
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW25721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ65298Medicare ID - Type Unspecified