Organization
MAINSTREET COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE ANGELLA PAYNE PHD, APRN-BC (CLINICAL DIRECTOR)
(301) 627-6816
Entity
Organization
Contact information
Practice address
14514 MAIN ST, UPPER MARLBORO, MD 20772-3059
(301) 627-6816
Mailing address
14514 MAIN ST, UPPER MARLBORO, MD 20772-3059
(301) 627-6816
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
RN117769
MD
Other
Enumeration date
12/03/2008
Last updated
12/03/2008
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