Provider Demographics
NPI:1407135536
Name:WORSHAM, JESSICA WILSON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:WILSON
Last Name:WORSHAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:WILSON
Other - Last Name:EPPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2610 COMMONS BLVD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-2080
Mailing Address - Country:US
Mailing Address - Phone:706-733-1935
Mailing Address - Fax:706-667-8727
Practice Address - Street 1:2610 COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-2080
Practice Address - Country:US
Practice Address - Phone:706-733-1935
Practice Address - Fax:706-667-8727
Is Sole Proprietor?:No
Enumeration Date:2011-08-07
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0041381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical