Provider Demographics
NPI:1467337063
Name:WORTHEM, OKWUCHI LILIAN
Entity type:Individual
Prefix:MRS
First Name:OKWUCHI
Middle Name:LILIAN
Last Name:WORTHEM
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 1:13970 HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:THAXTON
Mailing Address - State:MS
Mailing Address - Zip Code:38871-1006
Mailing Address - Country:US
Mailing Address - Phone:919-757-6312
Mailing Address - Fax:
Practice Address - Street 1:13970 HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:THAXTON
Practice Address - State:MS
Practice Address - Zip Code:38871-1006
Practice Address - Country:US
Practice Address - Phone:919-757-6312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSM114499104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker