Individual provider Active NPI

Susan Forde-Bunch, LCSW

  • Clinical Social Worker
  • Arvada, CO
National Provider Identifier
1508910043
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW985058 Issued in CO
Practice address
5460 Ward Rd
Suite 210
Arvada, CO 80002-1825
Phone
(303) 431-5641
Fax
(303) 467-1145
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW985058 CO Primary

Addresses

Primary practice location

5460 Ward Rd
Suite 210
Arvada, CO 80002-1825

Mailing address

5460 Ward Rd
Suite 210
Arvada, CO 80002-1825
Phone (303) 431-5641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090723000489 CO Practitioner - Clinical Social Worker 8729130679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5460 Ward Rd
Suite 210
Arvada, CO 80002-1806
Phone 30343156413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW985058COMDClinical Social Worker

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508910043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5460 WARD RD",
            "address_2": "SUITE 210",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800021825",
            "telephone_number": "303-431-5641",
            "fax_number": "303-467-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 WARD RD",
            "address_2": "SUITE 210",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800021825",
            "telephone_number": "303-431-5641",
            "fax_number": "303-467-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORDE-BUNCH",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "LCSW985058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

Verify at the official NPI Registry.