Provider Demographics
NPI:1083759138
Name:PINKSTON, JUNE (LCSW)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:PINKSTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 73RD ST STE B
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-1125
Mailing Address - Country:US
Mailing Address - Phone:806-794-3950
Mailing Address - Fax:
Practice Address - Street 1:3417 73RD ST STE B
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1125
Practice Address - Country:US
Practice Address - Phone:806-794-3950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0118011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00S30GMedicare ID - Type UnspecifiedMEDICARE