| Main Street Counseling, Llc | |
|
16 Ichabod Ln Allentown NJ 08501-1959 | |
| (609) 208-3053 | |
| Not Available |
| Full Name | Main Street Counseling, Llc |
|---|---|
| Speciality | Counselor |
| Location | 16 Ichabod Ln, Allentown, New Jersey |
| Authorized Official Name and Position | Justin Adam Kahn (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 6092083053 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Counseling, Llc 16 Ichabod Ln Allentown NJ 08501-1959 Ph: (609) 208-3053 | Main Street Counseling, Llc 16 Ichabod Ln Allentown NJ 08501-1959 Ph: (609) 208-3053 |
| NPI Number | 1043610140 |
|---|---|
| Provider Enumeration Date | 08/26/2014 |
| Last Update Date | 11/16/2021 |
| Certification Date | 11/11/2021 |
| Medicare PECOS PAC ID | 7113317694 |
|---|---|
| Medicare Enrollment ID | O20211124002278 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043610140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 37PC00415100 (New Jersey) | Primary |
| Provider Name | Harold Popowitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568526929 PECOS PAC ID: 1052590452 Enrollment ID: I20110131000625 |
| Provider Name | Dale Bromberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710184981 PECOS PAC ID: 1951684539 Enrollment ID: I20170206000240 |
| Provider Name | Jennifer Ferrari |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548698822 PECOS PAC ID: 1850749771 Enrollment ID: I20231201002611 |
| Provider Name | Patricia Ann Lieberman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164068151 PECOS PAC ID: 9436507332 Enrollment ID: I20231204001500 |
| Provider Name | Hannah Wheat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477994481 PECOS PAC ID: 1951759778 Enrollment ID: I20231204002970 |
| Provider Name | Miriam Rebekah Egan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881153732 PECOS PAC ID: 7113376955 Enrollment ID: I20231205004032 |
| Provider Name | Lori Amison |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326429531 PECOS PAC ID: 8325497605 Enrollment ID: I20231212002228 |
| Provider Name | Barbara Paquette |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437792744 PECOS PAC ID: 7113377078 Enrollment ID: I20231219002240 |
| Provider Name | Leighann N Carl |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679281422 PECOS PAC ID: 6608219852 Enrollment ID: I20240205004016 |
| Provider Name | Susan Conley |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1407970718 PECOS PAC ID: 8729124037 Enrollment ID: I20240221000921 |
| Provider Name | Christine A Davirro |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1467009845 PECOS PAC ID: 3779025994 Enrollment ID: I20240604000374 |
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