Healthcare Provider Details

I. General information

NPI: 1174861397
Provider Name (Legal Business Name): EMILY BROOKE BROWN LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 JOHN F KENNEDY PKWY STE 310
FORT COLLINS CO
80525-2658
US

IV. Provider business mailing address

1500 N GRANT ST STE R
DENVER CO
80203-1859
US

V. Phone/Fax

Practice location:
  • Phone: 970-422-7620
  • Fax: 303-484-6996
Mailing address:
  • Phone: 970-599-1772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0022313
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: