Provider Demographics
NPI:1821660879
Name:WEST, KAYLA MADISON (MSW)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:MADISON
Last Name:WEST
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 E BROADWAY BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-2837
Mailing Address - Country:US
Mailing Address - Phone:865-999-0601
Mailing Address - Fax:
Practice Address - Street 1:222 E BROADWAY BLVD STE 205
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-2837
Practice Address - Country:US
Practice Address - Phone:865-999-0601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-10
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical