Jordan Daniel Seidle, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC005900 Issued in PA

Practice address

4700 Wissahickon Ave
Philadelphia, PA 19144-4248

Phone

(215) 967-2130

Fax

(215) 967-2171

NPI assigned

Nov 29, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1861737066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST",
            "address_2": "SUITE 11511",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021320",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WISSAHICKON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444248",
            "telephone_number": "215-967-2130",
            "fax_number": "215-967-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIDLE",
        "first_name": "JORDAN",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-29",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC005900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Alan Seidel, PH.D.
• Henry Seidel, BS
• Gary Harmon Seidenberg, ED D
• Dawn E Seiders, M.D.
• Emily Claire Seidle, LCSW
• Tierra Yvette Seidle
• Arielle Beth Seidler
• Larry Seidman, D.O.
• Larry J. Seidman, D.M.D.
• Ellen J Seidmann, CADC

• Professional Counselor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.