Provider Demographics
NPI:1124600283
Name:SEEFRIED, GRETCHEN CAMPBELL (LSW)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:CAMPBELL
Last Name:SEEFRIED
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8561 E ILIFF DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-3807
Mailing Address - Country:US
Mailing Address - Phone:303-349-1075
Mailing Address - Fax:
Practice Address - Street 1:3955 E EXPOSITION AVE STE 501
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-5030
Practice Address - Country:US
Practice Address - Phone:720-438-4495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0009922538104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLSW.0009922538OtherCOLORADO DEPT OF REGULATORY AGENCIES