Provider Demographics
NPI:1316487200
Name:CORNERSTONE CHRISTIAN COUNSELING LOUISA,INC.
Entity type:Organization
Organization Name:CORNERSTONE CHRISTIAN COUNSELING LOUISA,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KENSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:606-638-3322
Mailing Address - Street 1:114 N VINSON AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:KY
Mailing Address - Zip Code:41230-1150
Mailing Address - Country:US
Mailing Address - Phone:606-638-3322
Mailing Address - Fax:
Practice Address - Street 1:114 N VINSON AVE
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230-1150
Practice Address - Country:US
Practice Address - Phone:606-638-3322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3252251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1911930832OtherCAQH