MEDICARE: CYNTHIA CARRASCO 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		NM

General Provider Information

NPI Number	:	1629796610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA CARRASCO LCSW

Provider Business Mailing Address
First Line	:	PO BOX 362
Second Line	:
City	:	DONA ANA
State	:	NM
Zip	:	88032-0362
Country	:	US
Telephone Number	:	575-201-3356
Fax Number	:

Provider Business Practice Location Address
First Line	:	1505 S DON ROSER DR STE A
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4596
Country	:	US
Telephone Number	:	575-680-0682
Fax Number	:

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

Provider Enumeration Date	:	08/16/2022
Last Update Date	:	06/03/2026

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