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General NPI Number Information
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NPI Number | 1457556672
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Entity Type | Individual
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Provider Name | JULIE ENKELMANN SMIRL PHD, LCPC
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Gender | Female
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 785 WALL ST STE 200
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City | O FALLON
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State | IL
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Zip | 62269-1959
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Country | US
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Telephone | 618-367-2194
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Fax | 618-726-2024
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Provider Business Mailing Address
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Address Line | 181 W BELLEVILLE ST
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City | NASHVILLE
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State | IL
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Zip | 62263-1446
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Country | US
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Telephone | 618-314-4894
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180005731
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License Number State | IL
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