Provider Demographics
NPI:1215096011
Name:WORTH, ELIZABETH A (LSCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:WORTH
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:SPAUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:6000 LAMAR AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3234
Mailing Address - Country:US
Mailing Address - Phone:913-831-2550
Mailing Address - Fax:913-826-1589
Practice Address - Street 1:6440 NIEMAN RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-3326
Practice Address - Country:US
Practice Address - Phone:913-826-4000
Practice Address - Fax:913-826-1589
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMSW 5899104100000X
KSLSCSW 42081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1174513444Medicaid
KS1174513444Medicaid