Provider Demographics
NPI:1295288066
Name:BROWN, ANNE
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 S TEJON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2139
Mailing Address - Country:US
Mailing Address - Phone:719-424-5330
Mailing Address - Fax:
Practice Address - Street 1:421 S TEJON ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2131
Practice Address - Country:US
Practice Address - Phone:719-424-5330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2023-06-14
Deactivation Date:2023-04-12
Deactivation Code:
Reactivation Date:2023-05-11
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
COACD.0001915101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health