Individual provider Active NPI

Jason Cantwell

  • Clinical Social Worker
  • Parkersburg, WV
National Provider Identifier
1073306742
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CP00945832 Issued in WV
Practice address
4421 Emerson Ave Ste 204
Parkersburg, WV 26104-1200
Phone
(304) 220-0041
Fax
(304) 220-0112
NPI assigned
May 27, 2025
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X BP00945832 WV
Clinical Social Worker 1041C0700X CP00945832 WV Primary

Addresses

Primary practice location

4421 Emerson Ave Ste 204
Parkersburg, WV 26104-1200

Mailing address

4421 Emerson Ave Ste 204
Parkersburg, WV 26104-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BP00945832WVMDSocial Worker
CP00945832WVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sane Space PLLC CurrentSince Jun 3, 2025 Accepting new patients

Locations

4421 Emerson Ave
Ste 204
Parkersburg, WV 26104
Phone (304) 220-0041

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1073306742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 EMERSON AVE STE 204",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261041200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 EMERSON AVE STE 204",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261041200",
            "telephone_number": "304-220-0041",
            "fax_number": "304-220-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTWELL",
        "first_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "BP00945832",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "CP00945832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.