Individual provider Active NPI

Ira Lee West

  • Marriage & Family Therapist
  • Brandon, FL
National Provider Identifier
1760299069
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMT3907 Issued in FL
Practice address
306 W Sadie St
Brandon, FL 33510-4440
Phone
(813) 438-5949
Fax
(813) 438-5951
NPI assigned
Dec 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMT3907 FL Primary

Addresses

Primary practice location

306 W Sadie St
Brandon, FL 33510-4440

Mailing address

306 W Sadie St
Brandon, FL 33510-4440
Phone (813) 438-5949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IMT3907FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Camille Mabin, LCSW LLC CurrentSince Dec 15, 2024 Accepting new patients

Locations

306 W Sadie St
Brandon, FL 33510
Phone (813) 438-5949

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1760299069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W SADIE ST",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104440",
            "telephone_number": "813-438-5949",
            "fax_number": "813-438-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W SADIE ST",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104440",
            "telephone_number": "813-438-5949",
            "fax_number": "813-438-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "IRA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-11",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "IMT3907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.