Provider Demographics
NPI:1063964732
Name:MIKELS, JUNE MICHELE (MSW, LSW, LCAC)
Entity type:Individual
Prefix:MS
First Name:JUNE
Middle Name:MICHELE
Last Name:MIKELS
Suffix:
Gender:F
Credentials:MSW, LSW, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 EXECUTIVE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2611
Mailing Address - Country:US
Mailing Address - Phone:317-844-5742
Mailing Address - Fax:317-844-5737
Practice Address - Street 1:90 EXECUTIVE DR
Practice Address - Street 2:SUITE A
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2611
Practice Address - Country:US
Practice Address - Phone:317-844-5742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87001494A101YA0400X
IN33007796A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)