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General NPI Number Information
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NPI Number | 1093819567
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Entity Type | Organization
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Legal Business Name | JASON A. SEIDEL, PSY.D. P.C.
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 04/26/2011
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Provider Practice Location Address
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Address Line | 1720 S BELLAIRE ST SUITE 204
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City | DENVER
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State | CO
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Zip | 80222-4304
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Country | US
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Telephone | 303-547-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 S BELLAIRE ST SUITE 204
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City | DENVER
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State | CO
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Zip | 80222-4304
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Country | US
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Telephone | 303-547-3700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JASON ANDREW SEIDEL
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Credential | PSY.D.
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Telephone | 303-377-0999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2511
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License Number State | CO
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