Provider Demographics
NPI:1285527598
Name:JEAN, JESSE
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:JEAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11201 SHAKER BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44104-3833
Mailing Address - Country:US
Mailing Address - Phone:740-935-3811
Mailing Address - Fax:216-609-3461
Practice Address - Street 1:11201 SHAKER BLVD STE 102
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-3833
Practice Address - Country:US
Practice Address - Phone:740-935-3811
Practice Address - Fax:216-609-3461
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator