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NPI Code Detail

MEDICARE: ANDREW GEORGE LEFAVE LCSW

MEDICARE: ANDREW GEORGE LEFAVE LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker09102TX
21041C0700XClinical Social WorkerNM

General Provider Information

NPI Number : 1437197944
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW GEORGE LEFAVE LCSW
Provider Business Mailing Address
First Line : 530 DE MOSS ST
Second Line :
City : LORDSBURG
State : NM
Zip : 88045-2618
Country : US
Telephone Number : 575-542-8384
Fax Number : 575-542-2388
Provider Business Practice Location Address
First Line : 1007 N POPE ST
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-5161
Country : US
Telephone Number : 575-388-1511
Fax Number : 575-313-8236
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2006
Last Update Date : 03/16/2018

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Directions to “ ANDREW GEORGE LEFAVE LCSW” Practice Location

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