Provider Demographics
NPI:1578730891
Name:SEASTRUM, CLAUDIA PETRA (MA LPC CAC III)
Entity Type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:PETRA
Last Name:SEASTRUM
Suffix:
Gender:F
Credentials:MA LPC CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 NORTH IOWA STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2478
Mailing Address - Country:US
Mailing Address - Phone:970-641-1911
Mailing Address - Fax:970-642-0309
Practice Address - Street 1:219 NORTH IOWA STREET
Practice Address - Street 2:SUITE A
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2478
Practice Address - Country:US
Practice Address - Phone:970-641-1911
Practice Address - Fax:970-642-0309
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4262101YA0400X
CO454101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)