Provider Demographics
NPI:1245587591
Name:STUART-WORTH, LORI A (LCSW)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:STUART-WORTH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4318 WAKEFIELD CT
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-3929
Mailing Address - Country:US
Mailing Address - Phone:580-222-1646
Mailing Address - Fax:
Practice Address - Street 1:4318 WAKEFIELD CT
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-3929
Practice Address - Country:US
Practice Address - Phone:580-222-1646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK63101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200442740AMedicaid