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NPI Code Detail

MEDICARE: JEREMY WEST LICDC, LISW-S

MEDICARE: JEREMY WEST LICDC, LISW-S
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
11041C0700XClinical Social WorkerLCSW00001115KY
21041C0700XClinical Social WorkerDP00946482WV
3171M00000XCase Manager/Care Coordinator
4101YA0400XAddiction (Substance Use Disorder) CounselorLICDC.162185OH
5104100000XSocial WorkerI.2405472.SUPVOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356844849
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY WEST LICDC, LISW-S
Provider Business Mailing Address
First Line : 517 3RD AVE
Second Line :
City : CHESAPEAKE
State : OH
Zip : 45619-1036
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 517 3RD AVE
Second Line :
City : CHESAPEAKE
State : OH
Zip : 45619-1036
Country : US
Telephone Number : 740-451-1455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2018
Last Update Date : 11/20/2025

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Directions to “ JEREMY WEST LICDC, LISW-S” Practice Location

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