MEDICARE: LINDA L KONOPCZYNSKI L.C.S.W.

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	992747	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	992747	OTHER	CO	PROFESSIONAL LICENSE

General Provider Information

NPI Number	:	1023087905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA L KONOPCZYNSKI L.C.S.W.

Provider Business Mailing Address
First Line	:	5310 WARD RD
Second Line	:	SUITE 106
City	:	ARVADA
State	:	CO
Zip	:	80002-1829
Country	:	US
Telephone Number	:	303-278-7418
Fax Number	:	888-341-5050

Provider Business Practice Location Address
First Line	:	2019 RIVER WEST DR
Second Line	:
City	:	WINDSOR
State	:	CO
Zip	:	80550-4616
Country	:	US
Telephone Number	:	907-371-7086
Fax Number	:

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	03/27/2013

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