MEDICARE: ANDREA FORLINA LCSW, MSW

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	12	CO

General Provider Information

NPI Number	:	1730263559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA FORLINA LCSW, MSW

Provider Business Mailing Address
First Line	:	11059 E BETHANY DR
Second Line	:	STE. 200
City	:	AURORA
State	:	CO
Zip	:	80014-2622
Country	:	US
Telephone Number	:	303-617-2300
Fax Number	:

Provider Business Practice Location Address
First Line	:	10782 E ALAMEDA AVE
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80012-1017
Country	:	US
Telephone Number	:	303-617-2691
Fax Number	:

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/08/2007

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