Provider Demographics
NPI:1174584213
Name:SOFORENKO, MARJORIE S (LCSW)
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:S
Last Name:SOFORENKO
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 1:2185 BROADWAY
Mailing Address - Street 2:SENIOR COUNSELING GROUP
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2534
Mailing Address - Country:US
Mailing Address - Phone:303-296-2244
Mailing Address - Fax:303-296-1709
Practice Address - Street 1:4686 E ASBURY CIRCLE
Practice Address - Street 2:AMBERWOOD COURT
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4723
Practice Address - Country:US
Practice Address - Phone:303-756-1566
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical