Provider Demographics
NPI:1851190029
Name:WORTHAM, GAY
Entity type:Individual
Prefix:
First Name:GAY
Middle Name:
Last Name:WORTHAM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4708 LATROBE TRACE WAY
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6954
Mailing Address - Country:US
Mailing Address - Phone:817-875-4436
Mailing Address - Fax:
Practice Address - Street 1:BEYOND THE GRAY SKY LLC, DBA PURSUIT OF HAPPINESS
Practice Address - Street 2:1700 COVEMEADOW DRIVE
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012
Practice Address - Country:US
Practice Address - Phone:903-316-0472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX523791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical