Provider Demographics
NPI:1053906602
Name:CAREY, JUNE (CDCA)
Entity type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:CAREY
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3889 LANSDALE RD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3119
Mailing Address - Country:US
Mailing Address - Phone:216-333-5772
Mailing Address - Fax:
Practice Address - Street 1:25201 CHAGRIN BLVD STE 390
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5637
Practice Address - Country:US
Practice Address - Phone:216-910-9015
Practice Address - Fax:216-910-9015
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH173138101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty