Organization
MAIN STREET MOBILE TREATMENT ASSOCIATES INC
Active
Other names
Main Street Community Mental Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE J RYAN PSYD (OFFICE COORDINATOR)
(410) 526-7882
Entity
Organization
Contact information
Practice address
37 MAIN ST, REISTERSTOWN, MD 21136-1236
(410) 526-7882
(410) 526-9855
Mailing address
37 MAIN ST, REISTERSTOWN, MD 21136-1236
(410) 526-7882
(410) 526-9855
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404353700
—
MD
Enumeration date
08/08/2006
Last updated
02/28/2019
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