Provider Demographics
NPI:1609264126
Name:JUNEARICK, ROBBIE LATON (LGSW)
Entity Type:Individual
Prefix:
First Name:ROBBIE
Middle Name:LATON
Last Name:JUNEARICK
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:ROBBIE
Other - Middle Name:LATON
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1316 SOMERVILLE RD SE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4305
Mailing Address - Country:US
Mailing Address - Phone:256-260-7361
Mailing Address - Fax:256-341-0747
Practice Address - Street 1:1307 E ELM ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-5318
Practice Address - Country:US
Practice Address - Phone:256-260-7361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-06
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3590G101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health