Individual provider Active NPI

Renee D Brown, M.A.

  • Mental Health Counselor
  • Pueblo, CO
National Provider Identifier
1093255168
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0016191 Issued in CO
Practice address
1624 Bonforte Blvd Ste D
Pueblo, CO 81001-1680
Phone
(719) 310-5228
Fax
(719) 696-9432
NPI assigned
Mar 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0016191 CO Primary

Addresses

Primary practice location

1624 Bonforte Blvd Ste D
Pueblo, CO 81001-1680

Mailing address

1624 Bonforte Blvd Ste D
Pueblo, CO 81001-1680
Phone (719) 310-5228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1093255168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 BONFORTE BLVD STE D",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011680",
            "telephone_number": "719-310-5228",
            "fax_number": "719-696-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 BONFORTE BLVD STE D",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011680",
            "telephone_number": "719-310-5228",
            "fax_number": "719-696-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "RENEE",
        "middle_name": "D",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-08",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "0016191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.