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General NPI Number Information
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NPI Number | 1386118685
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Entity Type | Individual
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Provider Name | JORDAN HERSELMAN MA, LPC, LAC
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Gender | Female
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Dates
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Enumeration Date | 01/20/2019
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Last Update Date | 04/27/2023
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Provider Practice Location Address
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Address Line | 899 N LOGAN ST STE 309
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City | DENVER
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State | CO
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Zip | 80203-3155
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Country | US
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Telephone | 512-787-0264
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Fax |
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Provider Business Mailing Address
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Address Line | 7890 W PORTLAND AVE
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City | LITTLETON
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State | CO
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Zip | 80128-4431
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Country | US
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Telephone | 512-787-0264
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC.0015166
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0015166
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License Number State | CO
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