MEDICARE: DR. TINA HOOPER

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	104100000X	Social Worker	37666	TX
2	106S00000X	Behavior Technician	37666	TX
3	171M00000X	Case Manager/Care Coordinator	37666	TX
4	1041C0700X	Clinical Social Worker	37666	TX
5	104100000X	Social Worker	SWB-2024-1155	NM
6	103K00000X	Behavior Analyst	37666	TX
7	101Y00000X	Counselor	37666	TX

General Provider Information

NPI Number	:	1649747395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TINA HOOPER

Provider Business Mailing Address
First Line	:	PO BOX 3141
Second Line	:
City	:	CARLSBAD
State	:	NM
Zip	:	88221-3141
Country	:	US
Telephone Number	:	575-725-5552
Fax Number	:	575-725-5552

Provider Business Practice Location Address
First Line	:	2324 W PIERCE ST
Second Line	:
City	:	CARLSBAD
State	:	NM
Zip	:	88220-3514
Country	:	US
Telephone Number	:	575-725-5552
Fax Number	:	575-725-5552

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

Provider Enumeration Date	:	10/31/2018
Last Update Date	:	03/10/2026

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Directions to “ DR. TINA HOOPER ” Practice Location

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