Provider Demographics
NPI:1083773097
Name:WILSON-CLARKIN, JUNE MARIE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:MARIE
Last Name:WILSON-CLARKIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:LAKEPORT
Mailing Address - State:CA
Mailing Address - Zip Code:95453-4848
Mailing Address - Country:US
Mailing Address - Phone:707-254-5672
Mailing Address - Fax:707-262-0291
Practice Address - Street 1:200 N MAIN ST STE-A
Practice Address - Street 2:
Practice Address - City:LAKEPORT
Practice Address - State:CA
Practice Address - Zip Code:95453-4832
Practice Address - Country:US
Practice Address - Phone:707-254-5672
Practice Address - Fax:707-262-0291
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43378106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist