MEDICARE: JUNE HUBER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	5419	CO
2	101YP2500X	Professional Counselor	3602	CO

General Provider Information

NPI Number	:	1225352420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUNE HUBER LPC

Provider Business Mailing Address
First Line	:	PO BOX 16302
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80935-6302
Country	:	US
Telephone Number	:	719-661-6164
Fax Number	:

Provider Business Practice Location Address
First Line	:	6402 MESEDGE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-1813
Country	:	US
Telephone Number	:	719-661-6164
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2010
Last Update Date	:	03/17/2010

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