Provider Demographics
NPI:1578012357
Name:WEST, LEAH (LMSW)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
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 1:6400 UPTOWN BLVD NE
Mailing Address - Street 2:SUITE 360W
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-0704
Mailing Address - Country:US
Mailing Address - Phone:505-855-9805
Mailing Address - Fax:505-848-9468
Practice Address - Street 1:6400 UPTOWN BLVD NE
Practice Address - Street 2:SUITE 360W
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-0704
Practice Address - Country:US
Practice Address - Phone:505-855-9805
Practice Address - Fax:505-848-9468
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX-097281041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool