Healthcare Provider Details

I. General information

NPI: 1932016490
Provider Name (Legal Business Name): IDK COUNSELING AND CONSULT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 EAGLE RANCH RD
EAGLE CO
81631
US

IV. Provider business mailing address

PO BOX 6841
EAGLE CO
81631-1063
US

V. Phone/Fax

Practice location:
  • Phone: 970-306-6103
  • Fax:
Mailing address:
  • Phone: 970-306-6103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. JORDAN SELDINE
Title or Position: CLINCIAN
Credential: LPC
Phone: 970-306-6103