Worthen, Mark David

Worthen, Mark David is an sole proprietor health care provider with primary practice located at 15720 Brixham Hill Ave Ste 300 , Charlotte NC 28277-4784. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Worthen, Mark David can be contacted via phone (980) 391-6309.

Contact Information

Primary practice address
15720 Brixham Hill Ave Ste 300 Charlotte NC 28277-4784
Phone: (980) 391-6309
Fax: (980) 729-5870
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Forensic 103TF0200X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X 1835 North Carolina
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1835 North Carolina

Profile Details

NPI number 1770502379
LBN Legal business name Worthen, Mark David
Credentials PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2006
Last updated May 18th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770502379 NPPES
North Carolina MEDICAID 6000718

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