Provider Demographics
NPI:1679689657
Name:WREN, JUNE (LPC)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:WREN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 GRANBY ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-2607
Mailing Address - Country:US
Mailing Address - Phone:757-962-9503
Mailing Address - Fax:757-962-2700
Practice Address - Street 1:1216 GRANBY ST
Practice Address - Street 2:SUITE 209
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-2607
Practice Address - Country:US
Practice Address - Phone:757-962-9503
Practice Address - Fax:757-962-2700
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002991101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional