Individual provider Active NPI

June Marie Wilson-Clarkin, LMFT

  • Marriage & Family Therapist
  • Lakeport, CA
National Provider Identifier
1083773097
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC43378 Issued in CA
Practice address
200 N Main St Ste-a
Lakeport, CA 95453-4832
Phone
(707) 254-5672
Fax
(707) 262-0291
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC43378 CA Primary

Addresses

Primary practice location

200 N Main St Ste-a
Lakeport, CA 95453-4832

Mailing address

200 N Main St Ste a
Lakeport, CA 95453-4848
Phone (707) 254-5672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240516002343 CA Practitioner - Marriage and Family Therapist 2365883774 Practice locations: Lakeport, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 N Main St
Suite B
Lakeport, CA 95453-4848
Phone (707) 254-5672

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC43378CAMDMarriage & Family Therapist
43378CAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1083773097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N MAIN ST STE A",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954534848",
            "telephone_number": "707-254-5672",
            "fax_number": "707-262-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N MAIN ST STE-A",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954534832",
            "telephone_number": "707-254-5672",
            "fax_number": "707-262-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON-CLARKIN",
        "first_name": "JUNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC43378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeport, CA

Sources for this page

Verify at the official NPI Registry.