Provider Demographics
NPI:1124105150
Name:CORNERSTONE COUNSELING SERVICES
Entity type:Organization
Organization Name:CORNERSTONE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:W
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS LCSW
Authorized Official - Phone:262-542-3255
Mailing Address - Street 1:741 N GRAND AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-4820
Mailing Address - Country:US
Mailing Address - Phone:262-542-3255
Mailing Address - Fax:262-542-0823
Practice Address - Street 1:741 N GRAND AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-4820
Practice Address - Country:US
Practice Address - Phone:262-542-3255
Practice Address - Fax:262-542-0823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4034-123251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health