Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wanda Socorro Ortiz Thayne, LCSW

Individual provider Clinical Social Worker · NPI 1417415464

Wanda Socorro Ortiz Thayne, LCSW is a Clinical Social Worker in Beavercreek, Ohio. Licensed in California, New Mexico, South Carolina and Utah. Registered with an NPI since 2019.

Licensed in
CA, NM, SC, UT
In the registry since
2019
Specialties on file
4
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

4199 Spruce Wood Dr
Beavercreek, OH 45432-4124
Phone: (808) 295-7362
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 98196273501 (UT)
Clinical Social Worker Taxonomy 1041C0700X · Licence 6307 (SC)
Clinical Social Worker Taxonomy 1041C0700X · Licence LCSW13132 (CA)
Clinical Social Worker Taxonomy 1041C0700X · Licence C2154 (NM)

Record details

NPI number1417415464
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedMarch 8, 2019
Last updated in NPPESMarch 8, 2019

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