Provider Demographics
NPI:1508910043
Name:FORDE-BUNCH, SUSAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:FORDE-BUNCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5460 WARD RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1825
Mailing Address - Country:US
Mailing Address - Phone:303-431-5641
Mailing Address - Fax:303-467-1145
Practice Address - Street 1:5460 WARD RD
Practice Address - Street 2:SUITE 210
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1825
Practice Address - Country:US
Practice Address - Phone:303-431-5641
Practice Address - Fax:303-467-1145
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLCSW9850581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical