Individual provider Active NPI

Andrea Lynette Rascon-Thorpe, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1649605015
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-08658 Issued in NM
Practice address
4308 Carlisle Blvd NE, Ste 210
Albuquerque, NM 87107-4849
Phone
(505) 269-7356
Fax
(505) 247-1020
NPI assigned
Sep 4, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C-08658 NM Primary
School Social Worker 1041S0200X X-08351 NM

Addresses

Primary practice location

4308 Carlisle Blvd NE, Ste 210
Albuquerque, NM 87107-4849

Mailing address

4308 Carlisle Blvd NE, Ste 210
Albuquerque, NM 87107-4849
Phone (505) 269-7356

Other identifiers 2

IdentifierTypeStateIssuer
42678340MedicaidNM
X-08351OtherNMSTATE OF NEW MEXICO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131000269 NM Practitioner - Clinical Social Worker 2264885847 Practice locations: Albuquerque, NM

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4308 Carlisle Blvd NE
Suite 210
Albuquerque, NM 87107-4849
Phone (505) 269-7356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X-08351NMMDSchool Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1649605015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 CARLISLE BLVD NE, STE 210",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074849",
            "telephone_number": "505-269-7356",
            "fax_number": "505-247-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4308 CARLISLE BLVD NE, STE 210",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074849",
            "telephone_number": "505-269-7356",
            "fax_number": "505-247-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASCON-THORPE",
        "first_name": "ANDREA",
        "middle_name": "LYNETTE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-04",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-08658",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NM",
            "license": "X-08351",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42678340",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NEW MEXICO",
            "identifier": "X-08351",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.