1609096411 NPI number — MRS. BOBBY NEWELL WEST LCSW, MSW

Table of content: MRS. BOBBY NEWELL WEST LCSW, MSW (NPI 1609096411)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609096411 NPI number — MRS. BOBBY NEWELL WEST LCSW, MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEST
Provider First Name:
BOBBY
Provider Middle Name:
NEWELL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW, MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609096411
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1416 LEGENDARY LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRISVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27560-7102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-425-5334
Provider Business Mailing Address Fax Number:
919-460-4361

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7406 CHAPEL HILL RD STE F
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27607-5039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-395-4614
Provider Business Practice Location Address Fax Number:
919-460-4361
Provider Enumeration Date:
04/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  C004444 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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