Provider Demographics
NPI:1518580232
Name:WEST, MIRANDA ELAINE (LPCC)
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:ELAINE
Last Name:WEST
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 S OGDEN ST APT 102
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2330
Mailing Address - Country:US
Mailing Address - Phone:865-659-4418
Mailing Address - Fax:
Practice Address - Street 1:265 S HARLAN ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-2261
Practice Address - Country:US
Practice Address - Phone:720-272-1289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health