Individual provider Active NPI

Andrew Justin Thrasher III, PHD

  • Clinical Psychologist
  • Bossier City, LA
National Provider Identifier
1902144645
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1412 Issued in LA
Practice address
5521 Airline Dr Ste B
Bossier City, LA 71111-6801
Phone
(318) 507-0621
Fax
(225) 208-1056
NPI assigned
Jan 30, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1412 LA Primary

Addresses

Primary practice location

5521 Airline Dr Ste B
Bossier City, LA 71111-6801

Mailing address

5113 Waters Edge Dr
Benton, LA 71006-2501
Phone (337) 244-1641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Psychotherapy Clinic LLC Clinical PastSince Jun 1, 2018 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1902144645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 WATERS EDGE DR",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710062501",
            "telephone_number": "337-244-1641",
            "fax_number": "225-208-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5521 AIRLINE DR STE B",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711116801",
            "telephone_number": "318-507-0621",
            "fax_number": "225-208-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THRASHER",
        "first_name": "ANDREW",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-30",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "LA",
            "license": "1412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.