Provider Demographics
NPI:1568776763
Name:ANDERSON, JUNE DELOY (LPC, LAC, MS)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:DELOY
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LPC, LAC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 ELK ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-7351
Mailing Address - Country:US
Mailing Address - Phone:605-343-7262
Mailing Address - Fax:605-343-7293
Practice Address - Street 1:350 ELK ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7351
Practice Address - Country:US
Practice Address - Phone:605-343-7262
Practice Address - Fax:605-343-7293
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD213035 NCC101Y00000X
SD05111242101YA0400X
SDLPC7086101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)