Provider Demographics
NPI:1386681864
Name:WORTH, JENNIFER (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:WORTH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 BELLEVIEW AVE STE 100A
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-1410
Mailing Address - Country:US
Mailing Address - Phone:816-312-5451
Mailing Address - Fax:816-207-0486
Practice Address - Street 1:4700 BELLEVIEW AVE STE 100A
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-1410
Practice Address - Country:US
Practice Address - Phone:816-312-5451
Practice Address - Fax:816-207-0486
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20130150501041C0700X
KS5923104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS14674OtherPREFERRED HEALTH SYSTEMS
KS835235OtherBLUE CROSS BLUE SHIELD