Healthcare Provider Details

I. General information

NPI: 1881265478
Provider Name (Legal Business Name): MAINSTAY CENTER FOR COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2021
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 N MAIN ST STE B3
WILLIAMSTOWN NJ
08094-1475
US

IV. Provider business mailing address

375 N MAIN ST STE B3
WILLIAMSTOWN NJ
08094-1475
US

V. Phone/Fax

Practice location:
  • Phone: 856-777-3178
  • Fax:
Mailing address:
  • Phone: 856-777-3178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY RENEE THOMPSON
Title or Position: OWNER
Credential: MS, LPC
Phone: 856-777-3178