Provider Demographics
NPI:1740209063
Name:WORLEY, LAURA L (LCSW-S, LCDC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:L
Last Name:WORLEY
Suffix:
Gender:F
Credentials:LCSW-S, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 104TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-6088
Mailing Address - Country:US
Mailing Address - Phone:806-790-1048
Mailing Address - Fax:
Practice Address - Street 1:4501 50TH ST STE 103
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-3628
Practice Address - Country:US
Practice Address - Phone:806-790-1048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10479101YA0400X
TX309061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178939801Medicaid
TX87523QOtherBLUE CROSS BLUE SHEILD