MEDICARE: ANDREW STEVEN THOMAS CPSW

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	175T00000X	Peer Specialist	1195	NM

General Provider Information

NPI Number	:	1184390593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW STEVEN THOMAS CPSW

Provider Business Mailing Address
First Line	:	2957 MAJESTIC TERRACE DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4627
Country	:	US
Telephone Number	:	575-386-5844
Fax Number	:

Provider Business Practice Location Address
First Line	:	3850 FOOTHILLS RD STE 1
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4632
Country	:	US
Telephone Number	:	575-386-5844
Fax Number	:

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

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	05/27/2026

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