Provider Demographics
NPI:1104101393
Name:BROOKSHIRE, JUNE ELIZABETH (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:JUNE
Middle Name:ELIZABETH
Last Name:BROOKSHIRE
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:MS
Other - First Name:JUNE
Other - Middle Name:JOHNSON
Other - Last Name:WINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:1901 CENTRAL DR
Mailing Address - Street 2:SUITE 700
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-5869
Mailing Address - Country:US
Mailing Address - Phone:817-726-3034
Mailing Address - Fax:817-283-0820
Practice Address - Street 1:1901 CENTRAL DR
Practice Address - Street 2:SUITE 700
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5869
Practice Address - Country:US
Practice Address - Phone:817-726-3034
Practice Address - Fax:817-283-0820
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63397101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional