Organization
MARY KATHLEEN WEST LCSW, INC
Active
Organization
MARY KATHLEEN WEST LCSW, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KATHLEEN WEST LCSW (OWNER)
(706) 253-9515
Entity
Organization
Contact information
Practice address
201 COVE RD, JASPER, GA 30143
(706) 253-9515
(706) 253-9516
Mailing address
201 COVE RD, JASPER, GA 30143
(706) 253-9515
(706) 253-9516
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW1362
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
939149656A
—
GA
Enumeration date
10/29/2009
Last updated
10/09/2020
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