Provider Demographics
NPI:1043568801
Name:GLENN, JUNE (LISW-CP)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:
Last Name:GLENN
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:MISS
Other - First Name:JUNE
Other - Middle Name:
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 WOODBARK CT
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-3270
Mailing Address - Country:US
Mailing Address - Phone:864-710-6517
Mailing Address - Fax:
Practice Address - Street 1:401 WOODBARK CT
Practice Address - Street 2:
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-3270
Practice Address - Country:US
Practice Address - Phone:864-710-6517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC88671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical