MEDICARE: JULIA ANNE KATZMAN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker		MO
2	1041C0700X	Clinical Social Worker	2020017493	MO
3	1041C0700X	Clinical Social Worker	2022027925
4	1041C0700X	Clinical Social Worker	2022027925	MO

General Provider Information

NPI Number	:	1477172203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA ANNE KATZMAN LCSW

Provider Business Mailing Address
First Line	:	8301 MARYLAND AVE STE 310
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63105-3660
Country	:	US
Telephone Number	:	314-761-7010
Fax Number	:

Provider Business Practice Location Address
First Line	:	8301 MARYLAND AVE STE 310
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63105-3660
Country	:	US
Telephone Number	:	314-761-7010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2020
Last Update Date	:	12/20/2022

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