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General NPI Number Information
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NPI Number | 1578075107
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Entity Type | Individual
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Provider Name | CHRISTOPHER WORTHEN CDCA
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Gender | Male
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 1948 N LIMESTONE ST
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City | SPRINGFIELD
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State | OH
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Zip | 45503-2648
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Country | US
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Telephone | 866-534-2639
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Fax | 800-480-7578
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Provider Business Mailing Address
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Address Line | 220 SARA ST
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City | URBANA
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State | OH
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Zip | 43078-1549
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Country | US
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Telephone | 937-896-6130
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | APS.001804
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.166569
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License Number State | OH
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