Main Street Counseling Center, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16044 Issued in TX

Legal business name

MAIN STREET COUNSELING CENTER, LLC

Practice address

621 N Main St
Suite 200
Grapevine, TX 76051-9213

Phone

(817) 886-5777

Fax

(817) 421-1950

NPI assigned

Apr 23, 2010

Organization subpart

No

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

Authorized official

Name

Sheri Lee Golly, LCSWNPI 1851447015

Title

Owner

Phone

(817) 886-5777

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Sheri L Golly, LCSW

  • Clinical Social Worker
  • Grapevine, TX
  • NPI 1851447015
  NPD (past) Authorized official
• Sable Elizabeth Gonyea, MSW, LCSW

  • Clinical Social Worker
  • Grapevine, TX
  • NPI 1336450451
  NPD (past)

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1609193002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 N MAIN ST",
            "address_2": "SUITE 200",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760519213",
            "telephone_number": "817-886-5777",
            "fax_number": "817-421-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 N MAIN ST",
            "address_2": "SUITE 200",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760519213",
            "telephone_number": "817-886-5777",
            "fax_number": "817-421-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "GOLLY",
        "authorized_official_first_name": "SHERI",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-886-5777",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "16044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063955102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Elizabeth Machisak, RN, MSN, FNP-C
• Made Sapiens LLC (Dr. Lift)
• Meghan Elizabeth Magill, PT, DPT
• Melissa Magnanti, PHARMD
• Magnolia Speaks Speech Therapy Center
• Abbey Renee Malamut, PT, DPT
• Amyn Malik, MD
• Nadia Malik, MD
• Gary L. Malone, M.D.
• Annette Mancuso, LPC

• Clinical Social Worker in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.