Provider Demographics
NPI:1376855965
Name:CHRISTIAN, JUNE P (LMHC)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:P
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11967-1343
Mailing Address - Country:US
Mailing Address - Phone:516-924-7139
Mailing Address - Fax:
Practice Address - Street 1:112 CRESTWOOD DR
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-1343
Practice Address - Country:US
Practice Address - Phone:516-924-7139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004462-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health