Provider Demographics
NPI:1518302819
Name:WORDEN, KRISTY ANN (LISW)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:ANN
Last Name:WORDEN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:ANN
Other - Last Name:ZAHORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3355 GLENDALE AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2426
Mailing Address - Country:US
Mailing Address - Phone:419-383-5322
Mailing Address - Fax:419-383-6235
Practice Address - Street 1:3355 GLENDALE AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2426
Practice Address - Country:US
Practice Address - Phone:419-383-5555
Practice Address - Fax:419-383-3113
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHS.0900591OtherOHIO LICENSE