Provider Demographics
NPI:1609096411
Name:WEST, BOBBY NEWELL (LCSW, MSW)
Entity type:Individual
Prefix:MRS
First Name:BOBBY
Middle Name:NEWELL
Last Name:WEST
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 LEGENDARY LANE
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7102
Mailing Address - Country:US
Mailing Address - Phone:919-425-5334
Mailing Address - Fax:919-460-4361
Practice Address - Street 1:7406 CHAPEL HILL RD STE F
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-5039
Practice Address - Country:US
Practice Address - Phone:919-395-4614
Practice Address - Fax:919-460-4361
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0044441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical