Provider Demographics
NPI:1356536239
Name:WORLEY, SUELLEN R (LCSW, LADC)
Entity type:Individual
Prefix:
First Name:SUELLEN
Middle Name:R
Last Name:WORLEY
Suffix:
Gender:F
Credentials:LCSW, LADC
Other - Prefix:
Other - First Name:SUELLEN
Other - Middle Name:R
Other - Last Name:ALLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:820 MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-3430
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:820 MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-3430
Practice Address - Country:US
Practice Address - Phone:207-653-2832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC4552101YA0400X
MELC111891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)