Individual
JACKIE LYNNE WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, LADAC
Contact information
Practice address
5400 GIBSON BLVD SE, ALBUQUERQUE, NM 87108-5566
(505) 841-8978
(505) 841-8977
Mailing address
2504 CAMINO ENTRADA, SANTA FE, NM 87507-4851
(505) 216-2727
(505) 365-1006
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4749
NM
101YM0800X
Mental Health Counselor
T-0098501
NM
101YP2500X
Professional Counselor
Primary
CTB-2022-0948
NM
Other
Enumeration date
05/08/2007
Last updated
01/09/2025
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