Provider Demographics
NPI:1245296763
Name:WEST, DARWIN RAY (LMFT)
Entity type:Individual
Prefix:
First Name:DARWIN
Middle Name:RAY
Last Name:WEST
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:DARWIN
Other - Middle Name:R
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:PO BOX 2375
Mailing Address - Street 2:
Mailing Address - City:SNOWFLAKE
Mailing Address - State:AZ
Mailing Address - Zip Code:85937-2375
Mailing Address - Country:US
Mailing Address - Phone:928-243-2908
Mailing Address - Fax:
Practice Address - Street 1:1141 E COOLEY ST STE L
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-5100
Practice Address - Country:US
Practice Address - Phone:928-243-5558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-24
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT10183106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ860878OtherAHCCCS