Organization
BY YOUR SIDE EMDR LLC
Active
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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