Provider Demographics
NPI:1700444577
Name:WELLS, JHEREL A SR (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:JHEREL
Middle Name:A
Last Name:WELLS
Suffix:SR
Gender:M
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4836 MONTICELLO BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2846
Mailing Address - Country:US
Mailing Address - Phone:216-338-2898
Mailing Address - Fax:216-486-6112
Practice Address - Street 1:4836 MONTICELLO BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2846
Practice Address - Country:US
Practice Address - Phone:216-338-2898
Practice Address - Fax:216-486-6112
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1201496104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker