Healthcare Provider Details

I. General information

NPI: 1558297911
Provider Name (Legal Business Name): JULIANNE MARIE ALTMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N 5TH ST STE 201
SAINT CHARLES MO
63301-1808
US

IV. Provider business mailing address

3908 SUMMERFIELD PKWY
SAINT CHARLES MO
63304-2648
US

V. Phone/Fax

Practice location:
  • Phone: 636-238-2615
  • Fax:
Mailing address:
  • Phone: 314-520-9595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: