Provider Demographics
NPI:1609889005
Name:WEST, SYLVIA LARK (MSSW)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:LARK
Last Name:WEST
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 BREMO RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2440
Mailing Address - Country:US
Mailing Address - Phone:804-270-1200
Mailing Address - Fax:804-285-1950
Practice Address - Street 1:2000 BREMO RD
Practice Address - Street 2:SUITE 203
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2440
Practice Address - Country:US
Practice Address - Phone:804-270-1200
Practice Address - Fax:804-285-1950
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040007851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA800002011Medicare ID - Type Unspecified