Provider Demographics
NPI:1649397936
Name:THURSTON, JUNE MURIEL (LSWC)
Entity Type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:MURIEL
Last Name:THURSTON
Suffix:
Gender:F
Credentials:LSWC
Other - Prefix:
Other - First Name:JUNE
Other - Middle Name:MURIEL
Other - Last Name:ADDINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04937-0378
Mailing Address - Country:US
Mailing Address - Phone:207-453-4365
Mailing Address - Fax:207-453-4371
Practice Address - Street 1:66 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:ME
Practice Address - Zip Code:04937-1337
Practice Address - Country:US
Practice Address - Phone:207-453-4365
Practice Address - Fax:207-453-4371
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELSX9164104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker