Mainstreet Counseling Services, Llc | |
14514 Main St Upper Marlboro MD 20772-3059 | |
(301) 627-6816 | |
Not Available |
Full Name | Mainstreet Counseling Services, Llc |
---|---|
Speciality | Counselor - Professional |
Location | 14514 Main St, Upper Marlboro, Maryland |
Authorized Official Name and Position | Jacqueline Angella Payne (CLINICAL DIRECTOR) |
Authorized Official Contact | 3016276816 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Mainstreet Counseling Services, Llc 14514 Main St Upper Marlboro MD 20772-3059 Ph: (301) 627-6816 | Mainstreet Counseling Services, Llc 14514 Main St Upper Marlboro MD 20772-3059 Ph: (301) 627-6816 |
NPI Number | 1104061258 |
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Provider Enumeration Date | 12/03/2008 |
Last Update Date | 12/03/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104061258 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | RN117769 (Maryland) | Primary |
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