Individual
STUART WORLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
186 BRIANS LAKE RD, MOUNTAIN REST, SC 29664-9111
(704) 576-5648
Mailing address
186 BRIANS LAKE RD, MOUNTAIN REST, SC 29664-9111
(704) 576-5648
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6487
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6847
STATE LICENSE CLINICAL MENTAL HEALTH COUNSELOR
SC
Enumeration date
06/19/2018
Last updated
06/19/2018
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