Provider Demographics
NPI:1912041401
Name:WEST, CLYTA A (LPC)
Entity Type:Individual
Prefix:
First Name:CLYTA
Middle Name:A
Last Name:WEST
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5324
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85376-5324
Mailing Address - Country:US
Mailing Address - Phone:623-910-9051
Mailing Address - Fax:623-583-3888
Practice Address - Street 1:12301 W BELL RD
Practice Address - Street 2:STE A102
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-9705
Practice Address - Country:US
Practice Address - Phone:623-910-9051
Practice Address - Fax:623-583-3888
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC 11593101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional