Provider Demographics
NPI:1992251771
Name:WEST, LATONYA (MHS, BSW, CADC)
Entity type:Individual
Prefix:MRS
First Name:LATONYA
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:MHS, BSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 215TH PL
Mailing Address - Street 2:
Mailing Address - City:SAUK VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60411
Mailing Address - Country:US
Mailing Address - Phone:708-833-8208
Mailing Address - Fax:
Practice Address - Street 1:1640 215TH PL
Practice Address - Street 2:
Practice Address - City:SAUK VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60411
Practice Address - Country:US
Practice Address - Phone:708-833-8208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)