NPIMap

Organization Active NPI

Main Street Counseling, LLC

  • Professional Counselor
  • Monroe, CT
National Provider Identifier
1538596374
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MAIN STREET COUNSELING, LLC
Practice address
115 Main St
Unit 4
Monroe, CT 06468-1662
Phone
(203) 449-7908
Fax
(203) 905-6752
NPI assigned
Oct 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Authorized official

Name
Tara E Beall-Gomes, NCC, LPCNPI 1841638913
Title
Owner
Phone
(203) 449-7908

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
School CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YS0200X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

115 Main St
Unit 4
Monroe, CT 06468-1662

Mailing address

115 Main St
Unit 4
Monroe, CT 06468-1662
Phone (203) 449-7908

National Provider Directory

National Provider Directory

Locations

115 Main St
Unit 4
Monroe, CT 06468
Phone (203) 449-7908

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1538596374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MAIN ST",
            "address_2": "UNIT 4",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064681662",
            "telephone_number": "203-449-7908",
            "fax_number": "203-905-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MAIN ST",
            "address_2": "UNIT 4",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064681662",
            "telephone_number": "203-449-7908",
            "fax_number": "203-905-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-10",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "BEALL-GOMES",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-449-7908",
        "authorized_official_credential": "NCC, LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; 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.