Healthcare Provider Details

I. General information

NPI: 1376774380
Provider Name (Legal Business Name): WORTH COUNSELING ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2009
Last Update Date: 08/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4507B LACLEDE AVE
SAINT LOUIS MO
63108-2103
US

IV. Provider business mailing address

3924 BLAINE AVE
SAINT LOUIS MO
63110-2631
US

V. Phone/Fax

Practice location:
  • Phone: 314-913-4864
  • Fax:
Mailing address:
  • Phone: 314-913-4864
  • Fax: 314-771-1232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2002018127
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAURA CROSS WORTH
Title or Position: OWNER
Credential: MSW, LCSW
Phone: 314-913-4864