Organization
MAIN STREET COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA E BEALL-GOMES NCC, LPC (OWNER)
(203) 449-7908
Entity
Organization
Contact information
Practice address
115 MAIN ST, UNIT 4, MONROE, CT 06468-1662
(203) 449-7908
(203) 905-6752
Mailing address
115 MAIN ST, UNIT 4, MONROE, CT 06468-1662
(203) 449-7908
(203) 905-6752
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
101YS0200X
School Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
10/10/2013
Last updated
03/10/2017
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