Jesse Michael West, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

664 Issued in SC

Practice address

1268 S 4TH St
Hartsville, SC 29550-0703

Phone

(843) 332-3422

Fax

(843) 332-3985

NPI assigned

Dec 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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

• Caresouth Carolina, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hartsville, SC
  • NPI 1720082571
  Medicare reassignment NPD
• Carolina Neurobehavioral Associates

  • Clinical Neuropsychologist
  • Florence, SC
  • NPI 1386940872
  NPD (past) Authorized official
• Caresouth Carolina Inc

  • Federally Qualified Health Center (FQHC)
  • Latta, SC
  • NPI 1972980621
  NPD (past)
• Caresouth Carolina, Inc

  • Federally Qualified Health Center (FQHC)
  • Society Hill, SC
  • NPI 1194763714
  NPD (past)
• Caresouth Carolina, Inc

  • Federally Qualified Health Center (FQHC)
  • Cheraw, SC
  • NPI 1285677443
  NPD (past)

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1609850825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1090",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295511090",
            "telephone_number": "843-857-0111",
            "fax_number": "843-857-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 S 4TH ST",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295500703",
            "telephone_number": "843-332-3422",
            "fax_number": "843-332-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "JESSE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PS0243",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• We the Forerunners
• Liston Alexander Weatherly Jr., APRN
• Amanda Jo Webb, PA-C
• Angela Wellman
• Wellness Boutique LLC
• Harold Neil Wheeler, M.D.
• Justin Kenneth Wheeler
• Brandy Hulsey White, MCD CCC-SLP
• Vedia Goodson White, RN
• Brianna Wilds, BS

• Clinical Psychologist in Hartsville, SC
• Providers in Hartsville, SC by specialty
• Clinical Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.