# MAIN STREET MENTAL HEALTH, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225216625
- **Authorized official:** MS. JOAN ST JEAN APRN (OWNER)
- **Authorized official phone:** (603) 738-2445

## Contact information

- **Practice address:** 11 CANAL ST, MEREDITH, NH 03253-5902
- **Practice address phone:** (603) 738-2445
- **Mailing address:** PO BOX 535, MEREDITH, NH 03253-0535
- **Mailing address phone:** (603) 738-2445
- **Mailing address fax:** (603) 279-7042

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 026459-23-08 | NH | Yes |

## Other

- **Enumeration date:** 02/07/2008
- **Last updated:** 12/08/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2152562 | CIGNA | — |
| 05 | — | 3072631 | — | NH |
| 01 | — | 50Y011206NH01 | ANTHEM | NH |