Provider Demographics
NPI:1609183037
Name:WEST, ELIZABETH E (MA, LPC CANDIDATE)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:E
Last Name:WEST
Suffix:
Gender:F
Credentials:MA, LPC CANDIDATE
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:E
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS SOCIAL SCIENCE
Mailing Address - Street 1:114 W DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:NOWATA
Mailing Address - State:OK
Mailing Address - Zip Code:74048-2601
Mailing Address - Country:US
Mailing Address - Phone:918-273-1841
Mailing Address - Fax:918-273-1843
Practice Address - Street 1:120 S TREATY RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-5326
Practice Address - Country:US
Practice Address - Phone:918-540-1511
Practice Address - Fax:918-542-7374
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK73103488Medicaid