Provider Demographics
NPI:1568927986
Name:WEST, LAURA LYNNETTE (LMSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNNETTE
Last Name:WEST
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 VIRGINIA PINE WAY STE 2
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-1871
Mailing Address - Country:US
Mailing Address - Phone:865-407-0071
Mailing Address - Fax:865-217-1109
Practice Address - Street 1:10700 VIRGINIA PINE WAY STE 2
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-1871
Practice Address - Country:US
Practice Address - Phone:865-407-0071
Practice Address - Fax:865-217-1109
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12352104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker