MEDICARE: CHRISTOPHER WORTHEN CDCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	175T00000X	Peer Specialist	APS.001804	OH
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	CDCA.166569	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578075107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER WORTHEN CDCA

Provider Business Mailing Address
First Line	:	220 SARA ST
Second Line	:
City	:	URBANA
State	:	OH
Zip	:	43078-1549
Country	:	US
Telephone Number	:	937-896-6130
Fax Number	:

Provider Business Practice Location Address
First Line	:	1948 N LIMESTONE ST
Second Line	:
City	:	SPRINGFIELD
State	:	OH
Zip	:	45503-2648
Country	:	US
Telephone Number	:	866-534-2639
Fax Number	:	800-480-7578

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2017
Last Update Date	:	08/21/2025

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Directions to “ CHRISTOPHER WORTHEN CDCA” Practice Location

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