Provider Demographics
NPI:1548473952
Name:JOHNSON, JUNE C
Entity type:Individual
Prefix:MS
First Name:JUNE
Middle Name:C
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JUNE
Other - Middle Name:C
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:451 HIDDEN SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36350-3653
Mailing Address - Country:US
Mailing Address - Phone:334-790-6245
Mailing Address - Fax:
Practice Address - Street 1:134 PREVATT RD
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-5427
Practice Address - Country:US
Practice Address - Phone:334-794-0731
Practice Address - Fax:334-671-9199
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2528101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional