MEDICARE: MR. CHASE ALLEN WORTH MA

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	101YM0800X	Mental Health Counselor	0020957	CO

General Provider Information

NPI Number	:	1780404400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHASE ALLEN WORTH MA

Provider Business Mailing Address
First Line	:	12211 W ALAMEDA PKWY STE 102
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-2825
Country	:	US
Telephone Number	:	918-808-3594
Fax Number	:

Provider Business Practice Location Address
First Line	:	12211 W ALAMEDA PKWY STE 102
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-2825
Country	:	US
Telephone Number	:	918-808-3594
Fax Number	:

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

Provider Enumeration Date	:	10/16/2024
Last Update Date	:	05/11/2026

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