Healthcare Provider Details

I. General information

NPI: 1457286163
Provider Name (Legal Business Name): EMBER AND ASH THERAPY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9429 SUNSET RIDGE DR NE
ROCKFORD MI
49341-7114
US

IV. Provider business mailing address

9429 SUNSET RIDGE DR NE
ROCKFORD MI
49341-7114
US

V. Phone/Fax

Practice location:
  • Phone: 989-387-4704
  • Fax:
Mailing address:
  • Phone: 989-387-4704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY ELIZABETH KOLENBRANDER
Title or Position: OWNER/LEAD THERAPIST
Credential: LLMSW, BS
Phone: 989-387-4704