| Main Street Counseling Center | |
|
158 N. Main Street Crown Point IN 46307 | |
| (219) 663-0888 | |
| (219) 663-0887 |
| Full Name | Main Street Counseling Center |
|---|---|
| Speciality | Counselor |
| Location | 158 N. Main Street, Crown Point, Indiana |
| Authorized Official Name and Position | Cynthia R Bejster (OWNER/OPERATOR) |
| Authorized Official Contact | 2196630888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Counseling Center 158 N. Main Street Crown Point IN 46307 Ph: (219) 663-0888 | Main Street Counseling Center 158 N. Main Street Crown Point IN 46307 Ph: (219) 663-0888 |
| NPI Number | 1407001506 |
|---|---|
| Provider Enumeration Date | 11/18/2008 |
| Last Update Date | 03/23/2016 |
| Medicare PECOS PAC ID | 1951690890 |
|---|---|
| Medicare Enrollment ID | O20160517001746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407001506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 32000721A (Indiana) | Primary |
| Provider Name | Erin R Stewart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780677542 PECOS PAC ID: 4880676865 Enrollment ID: I20060719000210 |
| Provider Name | Timothy Scott Gobek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730487273 PECOS PAC ID: 4082932488 Enrollment ID: I20150415001444 |
| Provider Name | Cynthia R Bejster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003942285 PECOS PAC ID: 0648569459 Enrollment ID: I20160518001457 |
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