Healthcare Provider Details

I. General information

NPI: 1821253469
Provider Name (Legal Business Name): CORNERSTONE FAMILY COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 05/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 POYNTZ AVE
MANHATTAN KS
66502-4145
US

IV. Provider business mailing address

1408 POYNTZ AVE
MANHATTAN KS
66502-4145
US

V. Phone/Fax

Practice location:
  • Phone: 785-776-4105
  • Fax: 785-537-2299
Mailing address:
  • Phone: 785-776-4105
  • Fax: 785-537-2299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL L WELSH
Title or Position: EXECTIVE DIRECTOR
Credential: PSYD
Phone: 785-776-4105