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Organization
JODY SEIP COUNSELING
Active
Organization
JODY SEIP COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODY SEIP LCSW (OWNER)
(309) 660-7122
Entity
Organization
Contact information
Practice address
103 N REGENCY DR, BLOOMINGTON, IL 61701-3570
(309) 660-7122
Mailing address
103 N REGENCY DR, BLOOMINGTON, IL 61701-3570
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149011166
LICENSE
IL
01
—
1699882332
TYPE 1 NPI
—
Enumeration date
03/22/2018
Last updated
03/22/2018
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