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General NPI Number Information
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NPI Number | 1891147682
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Entity Type | Individual
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Provider Name | CAROLYN WORLEY LICDC-CS LISW-S
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Gender | Female
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Dates
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Enumeration Date | 07/06/2016
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Last Update Date | 06/28/2019
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Provider Practice Location Address
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Address Line | 2222 VINE ST
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City | CINCINNATI
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State | OH
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Zip | 45219-1828
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Country | US
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Telephone | 513-381-5900
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Fax | 513-651-1163
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Provider Business Mailing Address
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Address Line | 2600 VICTORY PKWY
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City | CINCINNATI
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State | OH
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Zip | 45206-1711
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Country | US
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Telephone | 513-381-5900
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Fax | 513-651-1163
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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 | 101139
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S1450868
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License Number State | OH
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