Healthcare Provider Details

I. General information

NPI: 1083527444
Provider Name (Legal Business Name): CATHERINE ANN BRUMMET-PETERSON LCSW-11031
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 W GURLEY ST
PRESCOTT AZ
86301-3616
US

IV. Provider business mailing address

2755 W LOVE LN
PRESCOTT AZ
86305-8513
US

V. Phone/Fax

Practice location:
  • Phone: 928-778-2531
  • Fax: 928-778-2531
Mailing address:
  • Phone: 928-778-2531
  • Fax: 928-778-2531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License NumberLCSW-11031
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-11031
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberLCSW-11031
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: