Provider Demographics
NPI:1457647562
Name:SEAGREN, JOHANNA (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:JOHANNA
Middle Name:
Last Name:SEAGREN
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 1:2629 W MAIN ST
Mailing Address - Street 2:#145
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4609
Mailing Address - Country:US
Mailing Address - Phone:720-432-0714
Mailing Address - Fax:
Practice Address - Street 1:2629 W MAIN ST
Practice Address - Street 2:#145
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4609
Practice Address - Country:US
Practice Address - Phone:720-432-0714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor