Active NPI
Kyle David Bridgman, LMFT
- Marriage & Family Therapist
- Colorado Springs, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT.0001770
- Practice address
- 1785 N Academy Blvd Ste 100
Colorado Springs, CO 80909-2733 - Phone
- (719) 246-5693
- NPI assigned
- Apr 19, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT.0001770 | CO | Primary |
Addresses
Primary practice location
1785 N Academy Blvd Ste 100
Colorado Springs, CO 80909-2733
Mailing address
1785 N Academy Blvd Ste 100
Colorado Springs, CO 80909-2733
Phone (719) 246-5693
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9000183743 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT.0001770 | CO | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Project Ember Counseling | Marriage & Family Therapist | Current | Accepting new patients |
| Project Ember Counseling | Marriage & Family Therapist | Current | Accepting new patients |
| Project Ember Initiative | Marriage & Family Therapist | Current | Accepting new patients |
Locations
5540 N Academy Blvd
Ste 210
Colorado Springs, CO 80918
Phone (719) 330-3366
4360 Montebello Dr
Ste 400
Colorado Springs, CO 80918
Phone (719) 593-9228
1785 N Academy Blvd
Ste 100
Colorado Springs, CO 80909
Phone (719) 246-5693
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Marriage & Family Therapist
- Colorado Springs, CO
- NPI 1164014783
-
- Marriage & Family Therapist
- Colorado Springs, CO
- NPI 1720600455
-
- Marriage & Family Therapist
- Colorado Springs, CO
- NPI 1720797327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719964800000",
"number": "1477040905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1785 N ACADEMY BLVD STE 100",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809092733",
"telephone_number": "719-246-5693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1785 N ACADEMY BLVD STE 100",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809092733",
"telephone_number": "719-246-5693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIDGMAN",
"first_name": "KYLE",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-04-19",
"last_updated": "2024-07-03",
"certification_date": "2024-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": "CO",
"license": "MFT.0001770",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000183743",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.