Provider Demographics
NPI:1487123741
Name:BREWSTER, KRISTI (LPC, LAC)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:BREWSTER
Suffix:
Gender:F
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 FULTON CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80951-3202
Mailing Address - Country:US
Mailing Address - Phone:719-491-5280
Mailing Address - Fax:
Practice Address - Street 1:2531 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3119
Practice Address - Country:US
Practice Address - Phone:719-300-7021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP2500X
COACD.0001461101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
COACD.0001461OtherLICENSED ADDICTION COUNSELOR
COLPC.0016726OtherLICENSED PROFESSIONAL COUNSELOR