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General NPI Number Information
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NPI Number | 1649605015
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Entity Type | Individual
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Provider Name | ANDREA LYNETTE RASCON-THORPE LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/04/2013
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 4308 CARLISLE BLVD NE, STE 210
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-4849
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Country | US
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Telephone | 505-269-7356
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Fax | 505-247-1020
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Provider Business Mailing Address
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Address Line | 4308 CARLISLE BLVD NE, STE 210
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-4849
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Country | US
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Telephone | 505-269-7356
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Fax | 505-247-1020
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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 | C-08658
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | X-08351
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License Number State | NM
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