| Main Street Counseling Service | |
|
8 Marcella Avenue West Orange NJ 07052 | |
| (973) 736-2041 | |
| (973) 669-9683 |
| Full Name | Main Street Counseling Service |
|---|---|
| Speciality | Clinic/Center |
| Location | 8 Marcella Avenue, West Orange, New Jersey |
| Authorized Official Name and Position | Mary P Duguid (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9737362041 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Counseling Service 8 Marcella Avenue West Orange NJ 07052 Ph: (973) 736-2041 | Main Street Counseling Service 8 Marcella Avenue West Orange NJ 07052 Ph: (973) 736-2041 |
| NPI Number | 1578699070 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 10/30/2013 |
| Medicare PECOS PAC ID | 1658530688 |
|---|---|
| Medicare Enrollment ID | O20120312000570 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578699070 | NPI | - | NPPES |
| 0045128 | Medicaid | NJ | |
| A2721786 | Other | NJ | OXFORD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Mary P Duguid |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033245535 PECOS PAC ID: 1850348145 Enrollment ID: I20050408000018 |
| Provider Name | Elizabeth Allocca |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083165757 PECOS PAC ID: 8628336427 Enrollment ID: I20171228001451 |
| Provider Name | Allison K Mcclain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225674716 PECOS PAC ID: 2062881097 Enrollment ID: I20221213002030 |
| Provider Name | Amanda I Echevarria |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760933931 PECOS PAC ID: 2264801224 Enrollment ID: I20221213003388 |
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