Provider Demographics
NPI:1043356983
Name:MELTON, JUNE MARIE (LPC)
Entity type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:MARIE
Last Name:MELTON
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:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:HOLDENVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74848-0186
Mailing Address - Country:US
Mailing Address - Phone:405-221-2610
Mailing Address - Fax:
Practice Address - Street 1:3362 N 367 RD
Practice Address - Street 2:
Practice Address - City:HOLDENVILLE
Practice Address - State:OK
Practice Address - Zip Code:74848-9473
Practice Address - Country:US
Practice Address - Phone:405-221-2610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2340101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional