Provider Demographics
NPI:1780399071
Name:EMBER COUNSELING, PLLC
Entity type:Organization
Organization Name:EMBER COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPCC
Authorized Official - Prefix:
Authorized Official - First Name:KYLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-220-9547
Mailing Address - Street 1:4085 INTREPID CIR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-8851
Mailing Address - Country:US
Mailing Address - Phone:701-220-9547
Mailing Address - Fax:
Practice Address - Street 1:120 N 3RD ST STE 230
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-3874
Practice Address - Country:US
Practice Address - Phone:701-220-9547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1346653896Medicaid