Provider Demographics
NPI:1992427272
Name:WEST, MALYNDI (MED, LPC-A, LCDC-I)
Entity type:Individual
Prefix:
First Name:MALYNDI
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:MED, LPC-A, LCDC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 W 11TH ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-2052
Mailing Address - Country:US
Mailing Address - Phone:512-522-0299
Mailing Address - Fax:
Practice Address - Street 1:825 W 11TH ST STE 1A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2052
Practice Address - Country:US
Practice Address - Phone:512-522-0299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-14
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
TX89012101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)