Organization
MAIN STREET COUNSELING SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY P DUGUID LCSW (CLINICAL DIRECTOR)
(973) 736-2041
Entity
Organization
Contact information
Practice address
8 MARCELLA AVENUE, WEST ORANGE, NJ 07052
(973) 736-2041
(973) 669-9683
Mailing address
8 MARCELLA AVENUE, WEST ORANGE, NJ 07052
(973) 736-2041
(973) 669-9683
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0045128
—
NJ
01
—
A2721786
OXFORD
NJ
Enumeration date
02/26/2007
Last updated
10/30/2013
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