MEDICARE: LYNN C CUGINI LCSW

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	989962	CO

General Provider Information

NPI Number	:	1932121886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN C CUGINI LCSW

Provider Business Mailing Address
First Line	:	1143 AURARIA PKWY
Second Line	:	#204
City	:	DENVER
State	:	CO
Zip	:	80204-5803
Country	:	US
Telephone Number	:	303-304-0091
Fax Number	:	303-572-3558

Provider Business Practice Location Address
First Line	:	1615 CALIFORNIA ST
Second Line	:	SUITE 718
City	:	DENVER
State	:	CO
Zip	:	80202-3705
Country	:	US
Telephone Number	:	303-304-0091
Fax Number	:	303-572-3558

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

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	07/08/2007

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