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General NPI Number Information
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NPI Number | 1417383035
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Entity Type | Individual
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Provider Name | ANDREA PACHECO LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/16/2013
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Last Update Date | 02/02/2022
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Provider Practice Location Address
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Address Line | 5376 TOMAH DR STE 210
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-6968
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Country | US
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Telephone | 719-766-7163
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Fax | 720-650-8447
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Provider Business Mailing Address
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Address Line | 5376 TOMAH DR STE 200
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-6968
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Country | US
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Telephone | 719-766-7163
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Fax | 720-650-8447
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 09924856
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License Number State | CO
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