MEDICARE: MRS. ELIZA ROCHELLE THRASHER BA, QMHA

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	106S00000X	Behavior Technician
2	104100000X	Social Worker		NV
3	171M00000X	Case Manager/Care Coordinator		NV
4	172V00000X	Community Health Worker	CHW1-6490	NV

General Provider Information

NPI Number	:	1720970080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZA ROCHELLE THRASHER BA, QMHA

Provider Business Mailing Address
First Line	:	9541 WINDSOR FOREST CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4411
Country	:	US
Telephone Number	:	775-910-3782
Fax Number	:

Provider Business Practice Location Address
First Line	:	807 S DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-3933
Country	:	US
Telephone Number	:	702-983-8998
Fax Number	:

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

Provider Enumeration Date	:	07/18/2025
Last Update Date	:	04/07/2026

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