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NPI Code Detail

MEDICARE: KRISTI BREWSTER LPC, LAC

MEDICARE: KRISTI BREWSTER LPC, LAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor
3101YA0400XAddiction (Substance Use Disorder) CounselorACD.0001461CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ACD.0001461OTHERCOLICENSED ADDICTION COUNSELOR
2LPC.0016726OTHERCOLICENSED PROFESSIONAL COUNSELOR

General Provider Information

NPI Number : 1487123741
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTI BREWSTER LPC, LAC
Provider Business Mailing Address
First Line : 1905 FULTON CT
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80951-3202
Country : US
Telephone Number : 719-491-5280
Fax Number :
Provider Business Practice Location Address
First Line : 2531 AIRPORT RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80910-3119
Country : US
Telephone Number : 719-300-7021
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2018
Last Update Date : 10/23/2023

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Directions to “ KRISTI BREWSTER LPC, LAC” Practice Location

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