| Organization Name: | MAIN STREET MENTAL HEALTH, PLLC |
| NPI Number: | 1225216625 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOAN ST JEAN (OWNER) |
| Mailing Address: | 4 Water St Meredith |
| State: | NH US |
| Postal Code: | 032536237 |
| Phone Number: | 6032793937 |
| Fax Number: | 6032797042 |
| NPI Enumeration Date: | 02/07/2008 |
| NPI Last Update Date: | 03/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 026459-23-08 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |