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General NPI Number Information
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NPI Number | 1083123061
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Entity Type | Organization
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Legal Business Name | SHE COUNSELING LLC
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Dates
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Enumeration Date | 09/22/2017
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Last Update Date | 09/22/2017
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Provider Practice Location Address
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Address Line | 12021 PENNSYLVANIA ST STE 205
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City | THORNTON
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State | CO
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Zip | 80241-3152
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Country | US
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Telephone | 303-218-5259
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Fax |
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Provider Business Mailing Address
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Address Line | 13734 COLUMBINE ST
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City | THORNTON
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State | CO
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Zip | 80602-7243
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Country | US
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Telephone | 309-236-4831
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRANDY MARTIN
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Credential | LPC
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Telephone | 303-218-5259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 0013606
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0013606
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License Number State | CO
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