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NPI 1932016490

NPI 1932016490 : IDK COUNSELING AND CONSULT LLC : EAGLE, CO

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General NPI Number Information
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    NPI Number           |    1932016490
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    Entity Type          |    Organization 
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    Legal Business Name  |    IDK COUNSELING AND CONSULT LLC 
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Dates
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    Enumeration Date     |    08/27/2026
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    Last Update Date     |    09/02/2026
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Provider Practice Location Address
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    Address Line         |    333 EAGLE RANCH RD 
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    City                 |    EAGLE
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    State                |    CO
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    Zip                  |    81631
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    Country              |    US
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    Telephone            |    970-306-6103
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 6841 
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    City                 |    EAGLE
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    State                |    CO
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    Zip                  |    81631-1063
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    Country              |    US
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    Telephone            |    970-306-6103
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CLINCIAN
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    Name                 |    MS. JORDAN  SELDINE 
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    Credential           |    LPC
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    Telephone            |    970-306-6103
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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       |    
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    License Number State |    
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