Provider Demographics
NPI:1811661267
Name:WEST, ALEC BRANDON (MS, MFT-IT, SAC)
Entity type:Individual
Prefix:MR
First Name:ALEC
Middle Name:BRANDON
Last Name:WEST
Suffix:
Gender:M
Credentials:MS, MFT-IT, SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1268 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-1930
Mailing Address - Country:US
Mailing Address - Phone:608-834-1122
Mailing Address - Fax:
Practice Address - Street 1:1268 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-1930
Practice Address - Country:US
Practice Address - Phone:608-834-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-08
Last Update Date:2024-10-15
Deactivation Date:2024-09-09
Deactivation Code:
Reactivation Date:2024-10-15
Provider Licenses
StateLicense IDTaxonomies
WI17067-131101YA0400X
WI1109-228106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)