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General NPI Number Information
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NPI Number | 1376774380
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Entity Type | Organization
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Legal Business Name | WORTH COUNSELING ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/07/2009
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Last Update Date | 08/07/2009
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Provider Practice Location Address
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Address Line | 4507B LACLEDE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2103
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Country | US
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Telephone | 314-913-4864
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Fax |
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Provider Business Mailing Address
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Address Line | 3924 BLAINE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63110-2631
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Country | US
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Telephone | 314-913-4864
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Fax | 314-771-1232
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LAURA CROSS WORTH
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Credential | MSW, LCSW
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Telephone | 314-913-4864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2002018127
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License Number State | MO
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