Healthcare Provider Details

I. General information

NPI: 1487575247
Provider Name (Legal Business Name): NEUROFEEDBACK COLORADO SPRINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1283 KELLY JOHNSON BLVD STE 200
COLORADO SPRINGS CO
80920-3925
US

IV. Provider business mailing address

1283 KELLY JOHNSON BLVD STE 200
COLORADO SPRINGS CO
80920-3925
US

V. Phone/Fax

Practice location:
  • Phone: 719-413-6776
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: EMILY ANN INMAN
Title or Position: OWNER
Credential:
Phone: 719-413-6776