Provider Demographics
NPI:1215352695
Name:BALLARD, JUNE ROSEANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:ROSEANN
Last Name:BALLARD
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 1:7299 E 620 RD
Mailing Address - Street 2:
Mailing Address - City:PEGGS
Mailing Address - State:OK
Mailing Address - Zip Code:74452-2087
Mailing Address - Country:US
Mailing Address - Phone:918-208-8607
Mailing Address - Fax:
Practice Address - Street 1:7299 E 620 RD
Practice Address - Street 2:
Practice Address - City:PEGGS
Practice Address - State:OK
Practice Address - Zip Code:74452-2087
Practice Address - Country:US
Practice Address - Phone:918-208-8607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-21
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst