Provider Demographics
NPI:1386283034
Name:MAINSTREET COUNSELING
Entity type:Organization
Organization Name:MAINSTREET COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:608-324-4654
Mailing Address - Street 1:N4296 DUTCH HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-9366
Mailing Address - Country:US
Mailing Address - Phone:608-324-4654
Mailing Address - Fax:
Practice Address - Street 1:1717 11TH ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-1839
Practice Address - Country:US
Practice Address - Phone:608-214-6225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAINSTREET COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-29
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty