Provider Demographics
NPI:1013183524
Name:ALTMAN, MICHAEL JON (LPC, CACII)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JON
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:LPC, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1866
Mailing Address - Country:US
Mailing Address - Phone:720-480-2429
Mailing Address - Fax:303-665-4229
Practice Address - Street 1:844 MAIN ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1866
Practice Address - Country:US
Practice Address - Phone:720-480-2429
Practice Address - Fax:303-665-4229
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCAC II 3902101YA0400X
COLPC 951101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)