Provider Demographics
NPI:1992231427
Name:WORLOCK, RITA (LCSW, LPMFT, CASAC-T)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:WORLOCK
Suffix:
Gender:F
Credentials:LCSW, LPMFT, CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 OSWEGO ST
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-5178
Mailing Address - Country:US
Mailing Address - Phone:315-658-6496
Mailing Address - Fax:315-457-6000
Practice Address - Street 1:600 OSWEGO ST
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-5178
Practice Address - Country:US
Practice Address - Phone:315-658-6496
Practice Address - Fax:315-457-6000
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34985101YA0400X
NY103709104100000X
NYP03413106H00000X
NY0946451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist