MEDICARE: ROHINI CHANDRA CSW-C

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	1041C0700X	Clinical Social Worker	SWC.0000001418	CO

General Provider Information

NPI Number	:	1780441006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROHINI CHANDRA CSW-C

Provider Business Mailing Address
First Line	:	400 S COLORADO BLVD STE 530
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80246-1255
Country	:	US
Telephone Number	:	720-262-2644
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 ARAPAHOE AVE STE 200
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80303-1050
Country	:	US
Telephone Number	:	720-262-2644
Fax Number	:

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

Provider Enumeration Date	:	03/04/2024
Last Update Date	:	03/04/2024

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