Healthcare Provider Details

I. General information

NPI: 1700150166
Provider Name (Legal Business Name): MAINSTREAM MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2012
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 5TH ST NE
ROANOKE VA
24016-2123
US

IV. Provider business mailing address

PO BOX 745
DALEVILLE VA
24083-0745
US

V. Phone/Fax

Practice location:
  • Phone: 540-966-5808
  • Fax:
Mailing address:
  • Phone: 540-966-5808
  • Fax: 540-966-3470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1877-03-001
License Number StateVA

VIII. Authorized Official

Name: MR. MICHAEL PRESTON MORRIS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 540-309-4836