Provider Demographics
NPI:1639040439
Name:WORTHLEY, LEIGH
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:
Last Name:WORTHLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 PRAIRIE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-5385
Mailing Address - Country:US
Mailing Address - Phone:817-666-3068
Mailing Address - Fax:
Practice Address - Street 1:121 PRAIRIE AVE STE C
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-5385
Practice Address - Country:US
Practice Address - Phone:817-666-3068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96571101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional