Provider Demographics
NPI:1306055421
Name:COLBENSON, KATHERINE BROWN (LMFT)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:BROWN
Last Name:COLBENSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 BROWNWOOD AVE SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-3805
Mailing Address - Country:US
Mailing Address - Phone:404-564-3408
Mailing Address - Fax:
Practice Address - Street 1:3111 CLAIRMONT RD NE
Practice Address - Street 2:SUITE B
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-1015
Practice Address - Country:US
Practice Address - Phone:404-457-4753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT000582106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist