Provider Demographics
NPI:1164014783
Name:PROJECT EMBER COUNSELING
Entity type:Organization
Organization Name:PROJECT EMBER COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:719-246-5693
Mailing Address - Street 1:4360 MONTEBELLO DR STE 400
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-7224
Mailing Address - Country:US
Mailing Address - Phone:719-246-5693
Mailing Address - Fax:
Practice Address - Street 1:1722 E DALE ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-4617
Practice Address - Country:US
Practice Address - Phone:205-381-7344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROJECT EMBER COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-04
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty