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General NPI Number Information
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NPI Number | 1801025507
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Entity Type | Organization
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Legal Business Name | SUSAN FORDE-BUNCH PC
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Dates
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Enumeration Date | 07/02/2009
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Last Update Date | 07/02/2009
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Provider Practice Location Address
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Address Line | 5460 WARD RD SUITE 210
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City | ARVADA
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State | CO
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Zip | 80002-1825
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Country | US
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Telephone | 303-431-5641
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Fax | 303-467-1145
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Provider Business Mailing Address
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Address Line | 5460 WARD RD SUITE 210
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City | ARVADA
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State | CO
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Zip | 80002-1825
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Country | US
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Telephone | 303-431-5641
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Fax | 303-467-1145
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Authorized Official
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Title or Position | OWNER
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Name | MS. SUSAN FORDE-BUNCH
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Credential | LCSW
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Telephone | 303-431-5641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW 985058
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License Number State | CO
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