Healthcare Provider Details

I. General information

NPI: 1407774458
Provider Name (Legal Business Name): KATHERINE MARGARET BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N MAIN ST STE 306
PUEBLO CO
81003-4517
US

IV. Provider business mailing address

1920 N GREENWOOD ST
PUEBLO CO
81003-2643
US

V. Phone/Fax

Practice location:
  • Phone: 605-940-6319
  • Fax:
Mailing address:
  • Phone: 719-289-2695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0018812
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: