Provider Demographics
NPI:1407412877
Name:WORLTON, EMMA (CSW)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:WORLTON
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 W 3300 S APT 2087
Mailing Address - Street 2:
Mailing Address - City:S SALT LAKE
Mailing Address - State:UT
Mailing Address - Zip Code:84119-7127
Mailing Address - Country:US
Mailing Address - Phone:623-216-8407
Mailing Address - Fax:
Practice Address - Street 1:135 W CENTER ST
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-2207
Practice Address - Country:US
Practice Address - Phone:801-785-1169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-11
Last Update Date:2019-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11251852-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical