Provider Demographics
NPI:1457443731
Name:WEST, JEAN MARIE (PLCSW)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:MARIE
Last Name:WEST
Suffix:
Gender:F
Credentials:PLCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 S 39TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-2308
Mailing Address - Country:US
Mailing Address - Phone:816-364-5359
Mailing Address - Fax:816-671-4088
Practice Address - Street 1:1724 8TH AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64505-1811
Practice Address - Country:US
Practice Address - Phone:816-262-4494
Practice Address - Fax:816-671-4088
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060226831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical