Healthcare Provider Details

I. General information

NPI: 1821848383
Provider Name (Legal Business Name): JONATHAN WEST LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2024
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1283 N MAIN ST
HURRICANE UT
84737-2536
US

IV. Provider business mailing address

1283 N MAIN ST
HURRICANE UT
84737-2536
US

V. Phone/Fax

Practice location:
  • Phone: 330-606-3989
  • Fax:
Mailing address:
  • Phone: 435-767-1802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2871657
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberTPSW5503
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberTLS1326CP
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13668433-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: