Provider Demographics
NPI:1023160801
Name:WEST, CATHY M (PHD)
Entity type:Individual
Prefix:DR
First Name:CATHY
Middle Name:M
Last Name:WEST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 UPPER DRIVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-4137
Mailing Address - Country:US
Mailing Address - Phone:908-464-0107
Mailing Address - Fax:908-464-0851
Practice Address - Street 1:21 UPPER DRIVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-4137
Practice Address - Country:US
Practice Address - Phone:908-464-0107
Practice Address - Fax:908-464-0851
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100118600103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ584952Medicare ID - Type Unspecified