Provider Demographics
NPI:1063965184
Name:CORNERSTONE COUNSELING LLC
Entity type:Organization
Organization Name:CORNERSTONE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, NCC
Authorized Official - Phone:248-252-4931
Mailing Address - Street 1:52188 VAN DYKE AVE STE 103-104
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-3567
Mailing Address - Country:US
Mailing Address - Phone:248-252-4931
Mailing Address - Fax:866-820-9394
Practice Address - Street 1:52188 VAN DYKE AVE STE 103-104
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-3567
Practice Address - Country:US
Practice Address - Phone:248-252-4931
Practice Address - Fax:866-820-9394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012623251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health