Provider Demographics
NPI:1750421400
Name:RICHTER WEST, ALEDA M (MSW LCSW)
Entity type:Individual
Prefix:
First Name:ALEDA
Middle Name:M
Last Name:RICHTER WEST
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W CLARENDON
Mailing Address - Street 2:SUITE 140
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013
Mailing Address - Country:US
Mailing Address - Phone:602-277-0363
Mailing Address - Fax:602-277-5462
Practice Address - Street 1:300 W CLARENDON
Practice Address - Street 2:SUITE 140
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013
Practice Address - Country:US
Practice Address - Phone:602-277-0363
Practice Address - Fax:602-277-5462
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSW0657I1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZCSW657IMedicare ID - Type Unspecified