Individual
MR. DANIEL ANDREW SELOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS/CADC/LCPC
Contact information
Practice address
70 SANDY PT, GOREVILLE, IL 62939-3122
(618) 889-3987
(618) 351-1419
Mailing address
70 SANDY PT, GOREVILLE, IL 62939-3122
(618) 889-3987
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180006639
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03932079
BLUE CROSS BLUE SHIELD
IL
01
—
11826508
CAQH
IL
01
—
180006639
STATE LICENSE, LCPC
IL
Enumeration date
11/01/2006
Last updated
12/05/2025
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