Provider Demographics
NPI:1902221831
Name:WEST PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:WEST PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:901-505-1900
Mailing Address - Street 1:2600 POPLAR AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-3851
Mailing Address - Country:US
Mailing Address - Phone:901-359-9499
Mailing Address - Fax:901-328-5646
Practice Address - Street 1:2600 POPLAR AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-3851
Practice Address - Country:US
Practice Address - Phone:901-359-9499
Practice Address - Fax:901-328-5646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-01
Last Update Date:2014-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3036251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health