MAINSTREET COUNSELING SERVICES, LLC
NPI 1104061258
Counselor - Professional in Upper Marlboro, MD

Active since December 03, 2008
14514 MAIN ST, UPPER MARLBORO, MD 20772(301) 627-6816 Get Directions Write a Review

NPPES record last updated: December 3, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Counselor
  • Professional

About MAINSTREET COUNSELING SERVICES, LLC

This page provides the complete NPI Profile along with additional information for Mainstreet Counseling Services, Llc, a provider established in Upper Marlboro, Maryland operating as a Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1104061258 assigned on December 2008. The practitioner's primary taxonomy code is 101YP2500X with license number RN117769 (MD). The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Ms. Jacqueline Angella Payne Phd, Aprn-bc (Clinical Director)

NPI
1104061258 Verify this NPI
Provider Name
MAINSTREET COUNSELING SERVICES, LLC
Entity Type
Organization
Location Address
14514 MAIN ST UPPER MARLBORO, MD 20772
Location Phone
(301) 627-6816
Mailing Address
14514 MAIN ST UPPER MARLBORO, MD 20772
Mailing Phone
(301) 627-6816
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-03-2008
Last Update Date
12-03-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Counselor Professional

Taxonomy Code
101YP2500X
Type
Behavioral Health & Social Service Providers
License No.
RN117769
License State
MD

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MS. JACQUELINE ANGELLA PAYNE PHD, APRN-BC

Authorized Official Title
CLINICAL DIRECTOR
Authorized Official Phone
(301) 627-6816

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Registered Nurse (Psychiatric/Mental Health, Adult)
14514 MAIN ST
UPPER MARLBORO, MD 20772

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104061258, enumerated as an "organization" on December 03, 2008.

The provider is located at 14514 MAIN ST UPPER MARLBORO, MD 20772 and the phone number is (301) 627-6816.

Counselor with taxonomy code 101YP2500X and a focus in Professional.