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General NPI Number Information
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NPI Number | 1386283034
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Entity Type | Organization
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Legal Business Name | MAINSTREET COUNSELING
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Dates
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Enumeration Date | 12/29/2019
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 1717 11TH ST
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City | MONROE
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State | WI
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Zip | 53566-1839
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Country | US
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Telephone | 608-214-6225
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Fax |
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Provider Business Mailing Address
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Address Line | N4296 DUTCH HOLLOW RD
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City | MONROE
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State | WI
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Zip | 53566-9366
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Country | US
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Telephone | 608-324-4654
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGIE DOUGLAS
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Credential | LPC
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Telephone | 608-324-4654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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