Provider Demographics
NPI:1245692938
Name:PASCALE, TRISH (LADAC)
Entity type:Individual
Prefix:
First Name:TRISH
Middle Name:
Last Name:PASCALE
Suffix:
Gender:F
Credentials:LADAC
Other - Prefix:
Other - First Name:TRISH
Other - Middle Name:
Other - Last Name:PASCALE-WOODHULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2805 LAS VEGAS CT
Mailing Address - Street 2:STE B
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88007-4108
Mailing Address - Country:US
Mailing Address - Phone:575-491-3226
Mailing Address - Fax:
Practice Address - Street 1:718 10TH ST
Practice Address - Street 2:STE C
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6777
Practice Address - Country:US
Practice Address - Phone:575-434-8823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4392101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)