Provider Demographics
NPI:1568291896
Name:CORNERSTONE PSYCHIATRIC SERVICES INC
Entity type:Organization
Organization Name:CORNERSTONE PSYCHIATRIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:401-230-3261
Mailing Address - Street 1:595 PUTNAM PIKE LOWR LEVEL
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828-2145
Mailing Address - Country:US
Mailing Address - Phone:401-264-8941
Mailing Address - Fax:401-340-1957
Practice Address - Street 1:595 PUTNAM PIKE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828-2145
Practice Address - Country:US
Practice Address - Phone:401-230-3261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty