Provider Demographics
NPI:1568820967
Name:WEST, RATARSHA (LCAS-A)
Entity Type:Individual
Prefix:
First Name:RATARSHA
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 HIGHLAND AVE UNIT 20
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-4181
Mailing Address - Country:US
Mailing Address - Phone:336-397-7500
Mailing Address - Fax:336-397-7501
Practice Address - Street 1:725 HIGHLAND AVE UNIT 20
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-4181
Practice Address - Country:US
Practice Address - Phone:336-397-7500
Practice Address - Fax:336-397-7501
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-12664101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)