Healthcare Provider Details

I. General information

NPI: 1821992223
Provider Name (Legal Business Name): KYNDNESS BROSEMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 E CAMELBACK RD STE 200
PHOENIX AZ
85016-4363
US

IV. Provider business mailing address

2801 E CAMELBACK RD STE 200
PHOENIX AZ
85016-4363
US

V. Phone/Fax

Practice location:
  • Phone: 561-203-6085
  • Fax:
Mailing address:
  • Phone: 561-203-6085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLAC-24268
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: