MEDICARE: ASPEN TURGOOSE 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
1	1041C0700X	Clinical Social Worker	SWB-2023-0096	NM
2	1041C0700X	Clinical Social Worker	9498241-3502	UT

General Provider Information

NPI Number	:	1568231728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASPEN TURGOOSE LCSW

Provider Business Mailing Address
First Line	:	4007 LASSO LOOP
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-0824
Country	:	US
Telephone Number	:	801-682-7854
Fax Number	:

Provider Business Practice Location Address
First Line	:	4007 LASSO LOOP
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-0824
Country	:	US
Telephone Number	:	801-682-7854
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2023
Last Update Date	:	01/08/2026

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Directions to “ ASPEN TURGOOSE LCSW” Practice Location

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