Active NPI
Jerome Maurice West, OCPC, LCDC III
- Addiction (Substance Use Disorder) Counselor
- Cleveland Heights, OH
National Provider Identifier
1255875522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LCDCIII.161595
- Practice address
- 10 Severance Cir
Cleveland Heights, OH 44118-1533 - Phone
- (216) 778-3031
- NPI assigned
- Dec 6, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | W.1600042 | OH | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCDCIII.161595 | OH | Primary |
Addresses
Primary practice location
10 Severance Cir
Cleveland Heights, OH 44118-1533
Mailing address
10 Severance Cir
Cleveland Heights, OH 44118-1533
Phone (216) 778-3031
Other practice location 1
20611 Euclid Ave
Euclid, OH 44117-1521
Phone (855) 967-2436
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0275747 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LCDCIII.161595 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| W.1600042 | OH | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677542400000",
"number": "1255875522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 SEVERANCE CIR",
"city": "CLEVELAND HEIGHTS",
"state": "OH",
"postal_code": "441181533",
"telephone_number": "216-778-3031",
"fax_number": "216-417-8676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 SEVERANCE CIR",
"city": "CLEVELAND HEIGHTS",
"state": "OH",
"postal_code": "441181533",
"telephone_number": "216-778-3031"
}
],
"practiceLocations": [
{
"address_1": "20611 Euclid Ave",
"address_purpose": "LOCATION",
"city": "Euclid",
"state": "OH",
"postal_code": "441171521",
"country_code": "US",
"telephone_number": "855-967-2436",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEST",
"first_name": "JEROME",
"middle_name": "MAURICE",
"credential": "OCPC, LCDC III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-12-06",
"last_updated": "2023-02-28",
"certification_date": "2023-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "OH",
"license": "W.1600042",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "LCDCIII.161595",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0275747",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.