MEDICARE: JENNIFER WORTH LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	2013015050	MO
2	104100000X	Social Worker	5923	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14674	OTHER	KS	PREFERRED HEALTH SYSTEMS
2	835235	OTHER	KS	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1386681864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER WORTH LCSW

Provider Business Mailing Address
First Line	:	4700 BELLEVIEW AVE STE 100A
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64112-1410
Country	:	US
Telephone Number	:	816-312-5451
Fax Number	:	816-207-0486

Provider Business Practice Location Address
First Line	:	4700 BELLEVIEW AVE STE 100A
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64112-1410
Country	:	US
Telephone Number	:	816-312-5451
Fax Number	:	816-207-0486

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	10/11/2022

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Directions to “ JENNIFER WORTH LCSW” Practice Location

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