Healthcare Provider Details

I. General information

NPI: 1346791688
Provider Name (Legal Business Name): CORNERSTONE FAMILY THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 LINCOLNWAY W SUITE T
OSCEOLA IN
46561-2062
US

IV. Provider business mailing address

1415 LINCOLNWAY W SUITE T
OSCEOLA IN
46561-2062
US

V. Phone/Fax

Practice location:
  • Phone: 574-651-8912
  • Fax: 574-281-4412
Mailing address:
  • Phone: 574-651-8912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39002932A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number39002932A
License Number StateIN

VIII. Authorized Official

Name: MRS. BETTY MAE GUZMAN
Title or Position: THERAPIST
Credential: LMHC
Phone: 574-310-2410