Provider Demographics
NPI:1902696305
Name:WEST, JEREMY O'QUINN (LMSW)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:O'QUINN
Last Name:WEST
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:QUINN
Other - Middle Name:J
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:3701 DUBOSE ST SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35805-5027
Mailing Address - Country:US
Mailing Address - Phone:256-348-8708
Mailing Address - Fax:256-348-8708
Practice Address - Street 1:6767 OLD MADISON PIKE NW STE 620
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-4524
Practice Address - Country:US
Practice Address - Phone:256-517-7011
Practice Address - Fax:256-517-7011
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6333G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker