Organization
BY YOUR SIDE EMDR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY MARTIN LPC, LAC (LICENSED PROFESSIONAL COUNSELOR)
(303) 335-9134
Entity
Organization
Contact information
Practice address
2122 S LAFAYETTE ST, DENVER, CO 80210-4542
(303) 335-9134
Mailing address
2009 S HUMBOLDT ST, DENVER, CO 80210-3337
(303) 335-9134
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48539350
—
CO
Enumeration date
04/03/2024
Last updated
04/03/2024
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