Provider Demographics
NPI:1306948385
Name:WORTHINGTON, TERESA LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:LYNN
Last Name:WORTHINGTON
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 1:4021 IGOU CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7164
Mailing Address - Country:US
Mailing Address - Phone:205-394-9974
Mailing Address - Fax:
Practice Address - Street 1:1208 POINTE CENTRE DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3983
Practice Address - Country:US
Practice Address - Phone:615-406-3655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1189C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical