Provider Demographics
NPI:1699764076
Name:CAMPBELL-VANREMMEN, JUNE (LCSW)
Entity type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:CAMPBELL-VANREMMEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4184 SENECA ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3051
Mailing Address - Country:US
Mailing Address - Phone:716-675-4962
Mailing Address - Fax:716-675-4978
Practice Address - Street 1:4184 SENECA ST
Practice Address - Street 2:SUITE 208
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3051
Practice Address - Country:US
Practice Address - Phone:716-675-4962
Practice Address - Fax:716-675-4978
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR045342-1101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00020374802OtherUNIVERA HEALTH
NY000525457004OtherBLUE CROSS/BLUE SHIELD
NY6210970OtherINDEPENDENT HEALTH
NY137910OtherVALUE OPTIONS
NYBB0352Medicare ID - Type Unspecified