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General NPI Number Information
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NPI Number | 1548703150
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Entity Type | Individual
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Provider Name | LINDSAY WORTHAM MA, CAC II, LPCC
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Gender | Female
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Dates
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Enumeration Date | 11/30/2016
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Last Update Date | 12/07/2022
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Provider Practice Location Address
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Address Line | 2020 GRAND AVE SUITE 415
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City | LARAMIE
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State | WY
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Zip | 82070
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Country | US
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Telephone | 307-223-1048
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2420
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City | LARAMIE
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State | WY
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Zip | 82073
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Country | US
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Telephone | 307-223-1048
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACB.0008061
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPCC.0014385
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0013596
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC1835
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License Number State | WY
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