Provider Demographics
NPI:1831496652
Name:WEST, TANIKA JOHARI (P-LCSW)
Entity Type:Individual
Prefix:MISS
First Name:TANIKA
Middle Name:JOHARI
Last Name:WEST
Suffix:
Gender:F
Credentials:P-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-6505
Mailing Address - Country:US
Mailing Address - Phone:828-404-1932
Mailing Address - Fax:
Practice Address - Street 1:209 BROAD ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-6505
Practice Address - Country:US
Practice Address - Phone:828-404-1932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0053341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical