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NPI Code Detail

MEDICARE: JHEREL A WELLS SR. MSW, LSW

MEDICARE:   JHEREL A WELLS SR. MSW, LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerS.1201496OH

General Provider Information

NPI Number : 1700444577
Entity Type Code : Individual
Provider Name (Legal Business Name) : JHEREL A WELLS SR. MSW, LSW
Provider Business Mailing Address
First Line : 4836 MONTICELLO BLVD
Second Line :
City : RICHMOND HEIGHTS
State : OH
Zip : 44143-2846
Country : US
Telephone Number : 216-338-2898
Fax Number : 216-486-6112
Provider Business Practice Location Address
First Line : 4836 MONTICELLO BLVD
Second Line :
City : RICHMOND HEIGHTS
State : OH
Zip : 44143-2846
Country : US
Telephone Number : 216-338-2898
Fax Number : 216-486-6112
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2019
Last Update Date : 06/05/2019

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