Provider Demographics
NPI:1326229915
Name:WORLDS, MARY C
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:C
Last Name:WORLDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6460 BENTLEY CV
Mailing Address - Street 2:
Mailing Address - City:HORN LAKE
Mailing Address - State:MS
Mailing Address - Zip Code:38637-7323
Mailing Address - Country:US
Mailing Address - Phone:662-910-0425
Mailing Address - Fax:662-357-7396
Practice Address - Street 1:6460 BENTLEY CV
Practice Address - Street 2:
Practice Address - City:HORN LAKE
Practice Address - State:MS
Practice Address - Zip Code:38637-7323
Practice Address - Country:US
Practice Address - Phone:662-910-0425
Practice Address - Fax:662-357-7396
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-24
Last Update Date:2007-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC64281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04226377Medicaid