Provider Demographics
NPI:1598329732
Name:WEST, DEBRA LYNN
Entity Type:Individual
Prefix:MISS
First Name:DEBRA
Middle Name:LYNN
Last Name:WEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16318 JAMAICA AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4901
Mailing Address - Country:US
Mailing Address - Phone:718-658-0010
Mailing Address - Fax:718-658-2909
Practice Address - Street 1:16318 JAMAICA AVE STE 5
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4901
Practice Address - Country:US
Practice Address - Phone:718-658-0010
Practice Address - Fax:718-658-2909
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)