Provider Demographics
NPI:1033243514
Name:EANES, JUNE (CAC-AD CFAE CCJP)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:EANES
Suffix:
Gender:F
Credentials:CAC-AD CFAE CCJP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 CHURCHILL RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4227
Mailing Address - Country:US
Mailing Address - Phone:410-838-8533
Mailing Address - Fax:
Practice Address - Street 1:604 CHURCHILL RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4227
Practice Address - Country:US
Practice Address - Phone:410-838-8533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC0570101YA0400X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)