Healthcare Provider Details

I. General information

NPI: 1710241971
Provider Name (Legal Business Name): CASEY MARIE THARPE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 PEPPOLI LOOP SE
RIO RANCHO NM
87124-8778
US

IV. Provider business mailing address

1424 PEPPOLI LOOP SE
RIO RANCHO NM
87124-8778
US

V. Phone/Fax

Practice location:
  • Phone: 505-948-0460
  • Fax:
Mailing address:
  • Phone: 505-948-0460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberSWB-2025-0242
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: