Provider Demographics
NPI:1518059260
Name:WEST, COLLEEN (MSW)
Entity Type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:COLLEEN
Other - Middle Name:
Other - Last Name:TIGHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:175 LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-2332
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:175 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-2332
Practice Address - Country:US
Practice Address - Phone:859-269-7365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1232104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker