Provider Demographics
NPI:1720797327
Name:PROJECT EMBER INITIATIVE
Entity type:Organization
Organization Name:PROJECT EMBER INITIATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / CLINICAL DIRECTOR
Authorized Official - Prefix:
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 1:1785 N ACADEMY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-2733
Mailing Address - Country:US
Mailing Address - Phone:719-246-5693
Mailing Address - Fax:
Practice Address - Street 1:1785 N ACADEMY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-2733
Practice Address - Country:US
Practice Address - Phone:719-246-5693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-22
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty