Provider Demographics
NPI:1073108635
Name:VANGSTAD, CLAUDIA JEAN (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:JEAN
Last Name:VANGSTAD
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 WILD FERN DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:OR
Mailing Address - Zip Code:97495-8964
Mailing Address - Country:US
Mailing Address - Phone:541-430-0146
Mailing Address - Fax:
Practice Address - Street 1:411 WILD FERN DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:OR
Practice Address - Zip Code:97495-8964
Practice Address - Country:US
Practice Address - Phone:541-430-0146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT35197101YP2500X
ORC0966101YP2500X
AK142196101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional