# FREDA WORTHON, M.ED LICENSE PROFESSIONAL COUNSELOR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578864674
- **Authorized official:** MRS. FREDA ANNETTE WORTHON M.ED. (LICENSE PROFESSIONAL COUNSELOR)
- **Authorized official phone:** (417) 881-1249

## Contact information

- **Practice address:** 5793 S MICHIGAN AVE, SPRINGFIELD, MO 65810-2593
- **Practice address phone:** (417) 881-1249
- **Practice address fax:** (417) 881-1249
- **Mailing address:** 5793 S MICHIGAN AVE, SPRINGFIELD, MO 65810-2593
- **Mailing address phone:** (417) 881-1249
- **Mailing address fax:** (417) 881-1249

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 276400000X | Substance Use Disorder Rehabilitation Hospital Unit | 1999136664 | MO | Yes |

## Other

- **Enumeration date:** 11/06/2010
- **Last updated:** 01/04/2011