| Doctor Name: | JEREMY SCOTT WORSLEY |
| NPI Number: | 1063698314 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMSW |
| License Number: | 6801081983 |
| Business Practice Address: | 102 S.third St Suite 500 Carson City, MI - 48811 |
| Business Phone Number: | 9895843971 |
| Business Fax Number: | 9895846734 |
| Mailing Address: | Po Box 417, CARSON CITY |
| State: | MI |
| Postal Code: | 488110417 |
| Phone Number: | 9895846472 |
| Fax Number: | 9895843747 |
| NPI Enumeration Date: | 01/17/2008 |
| NPI Last Update Date: | 01/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 6801081983 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |