Provider Demographics
NPI:1396145181
Name:ACEVEDO-SEDA, NATALIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:ACEVEDO-SEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 CANVAS RIDGE AVE UNIT D
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-8048
Mailing Address - Country:US
Mailing Address - Phone:689-203-2421
Mailing Address - Fax:
Practice Address - Street 1:321 CANVAS RIDGE AVE UNIT D
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-8048
Practice Address - Country:US
Practice Address - Phone:689-203-2421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-19-10322103K00000X
1-20-42986103K00000X, 103K00000X
104100000X, 106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician