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General NPI Number Information
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NPI Number | 1407001506
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Entity Type | Organization
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Legal Business Name | MAIN STREET COUNSELING CENTER
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 158 N. MAIN STREET
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City | CROWN POINT
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State | IN
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Zip | 46307
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Country | US
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Telephone | 219-663-0888
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Fax | 219-663-0887
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Provider Business Mailing Address
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Address Line | 158 N. MAIN STREET
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City | CROWN POINT
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State | IN
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Zip | 46307
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Country | US
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Telephone | 219-663-0888
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Fax | 219-663-0887
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MRS. CYNTHIA R BEJSTER
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Credential | MSW, LCSW
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Telephone | 219-663-0888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 32000721A
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License Number State | IN
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