Provider Demographics
NPI:1730656224
Name:WORTHY, BEVERLY (LSW, LCDCLLL, OCPSL)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:WORTHY
Suffix:
Gender:F
Credentials:LSW, LCDCLLL, OCPSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 READING RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1413
Mailing Address - Country:US
Mailing Address - Phone:513-629-2300
Mailing Address - Fax:513-629-2311
Practice Address - Street 1:1617 READING RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-1413
Practice Address - Country:US
Practice Address - Phone:513-629-2300
Practice Address - Fax:513-629-2311
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS-0015710104100000X
OH0429-S90405300000X
OHLCDCLLL-081236101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No405300000XOther Service ProvidersPrevention Professional