Provider Demographics
NPI:1962130419
Name:BRIGHT SPACE COUNSELING
Entity type:Organization
Organization Name:BRIGHT SPACE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DEL PILAR
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-645-5637
Mailing Address - Street 1:1611 S MURRAY BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916-4502
Mailing Address - Country:US
Mailing Address - Phone:719-645-5637
Mailing Address - Fax:
Practice Address - Street 1:2864 S CIRCLE DR STE 350
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4165
Practice Address - Country:US
Practice Address - Phone:719-645-5637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIGHT SPACE COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-11
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty