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NPI Code Detail

MEDICARE: CAROL QUATMAN PORAT LCSW

MEDICARE: CAROL QUATMAN PORAT 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
11041C0700XClinical Social Worker992826CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730203365
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL QUATMAN PORAT LCSW
Provider Business Mailing Address
First Line : 2135 SOUTHGATE RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-2605
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2135 SOUTHGATE RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-2605
Country : US
Telephone Number : 719-633-4114
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 07/08/2007

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