Provider Demographics
NPI:1699888693
Name:VEST, JANE S (MSW LCSW)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:S
Last Name:VEST
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:E
Other - Last Name:VEST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:103A SOUTHPOINTE
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-3651
Mailing Address - Country:US
Mailing Address - Phone:618-656-7074
Mailing Address - Fax:618-656-1169
Practice Address - Street 1:103A SOUTHPOINTE
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-3651
Practice Address - Country:US
Practice Address - Phone:618-656-7074
Practice Address - Fax:618-656-1169
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical