Provider Demographics
NPI:1063605111
Name:BETTYE WEST & ASSOCIATES, INC.
Entity type:Organization
Organization Name:BETTYE WEST & ASSOCIATES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-709-8110
Mailing Address - Street 1:4404 S FLORIDA AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2169
Mailing Address - Country:US
Mailing Address - Phone:863-709-8110
Mailing Address - Fax:863-709-8118
Practice Address - Street 1:4404 S FLORIDA AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2169
Practice Address - Country:US
Practice Address - Phone:863-709-8110
Practice Address - Fax:863-709-8118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty