NPIMap

Organization Active NPI

Mainstreet Counseling Services, LLC

  • Professional Counselor
  • Upper Marlboro, MD
National Provider Identifier
1104061258
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
RN117769 Issued in MD
Legal business name
MAINSTREET COUNSELING SERVICES, LLC
Practice address
14514 Main St
Upper Marlboro, MD 20772-3059
Phone
(301) 627-6816
NPI assigned
Dec 3, 2008
Last updated
Dec 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Authorized official

Name
Ms. Jacqueline Angella Payne, PHD, APRN-BC
Title
Clinical Director
Phone
(301) 627-6816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X RN117769 MD Primary

Addresses

Primary practice location

14514 Main St
Upper Marlboro, MD 20772-3059

Mailing address

14514 Main St
Upper Marlboro, MD 20772-3059
Phone (301) 627-6816

National Provider Directory

National Provider Directory

Locations

14514 Main St
Upper Marlboro, MD 20772
Phone (301) 627-6816

NPI Registry JSON

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228262400000",
    "number": "1104061258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14514 MAIN ST",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723059",
            "telephone_number": "301-627-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14514 MAIN ST",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723059",
            "telephone_number": "301-627-6816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINSTREET COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-03",
        "last_updated": "2008-12-03",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "ANGELLA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "301-627-6816",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHD, APRN-BC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "RN117769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.