Individual
MARK DAVID WORTHEN
Active
Individual
MARK DAVID WORTHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
1835
NC
103TC0700X
Clinical Psychologist
Primary
1835
NC
103TF0200X
Forensic Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000718
—
NC
Enumeration date
07/18/2006
Last updated
05/18/2024
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