Provider Demographics
NPI:1043494529
Name:WORTH, AMOS TINGLEY
Entity Type:Individual
Prefix:MR
First Name:AMOS
Middle Name:TINGLEY
Last Name:WORTH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 PALMER ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-1118
Mailing Address - Country:US
Mailing Address - Phone:617-460-1981
Mailing Address - Fax:
Practice Address - Street 1:927 MASSACHUSETTS AVE STE 3
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4627
Practice Address - Country:US
Practice Address - Phone:617-460-1981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2021-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1159601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical