Provider Demographics
NPI:1598534570
Name:WEST, DEAN M (LSAT, CPSS, AAS-ASUD)
Entity Type:Individual
Prefix:MR
First Name:DEAN
Middle Name:M
Last Name:WEST
Suffix:
Gender:M
Credentials:LSAT, CPSS, AAS-ASUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 S 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-5433
Mailing Address - Country:US
Mailing Address - Phone:928-228-3439
Mailing Address - Fax:
Practice Address - Street 1:690 S 25TH AVE
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-5433
Practice Address - Country:US
Practice Address - Phone:928-228-3439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLSAT-7851T101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)