Healthcare Provider Details

I. General information

NPI: 1215646963
Provider Name (Legal Business Name): CORNERSTONE MONTGOMERY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2022
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29948 THREE NOTCH RD STE 7
CHARLOTTE HALL MD
20622-9998
US

IV. Provider business mailing address

2 TAFT CT STE 200
ROCKVILLE MD
20850-1390
US

V. Phone/Fax

Practice location:
  • Phone: 240-376-6650
  • Fax: 410-535-4965
Mailing address:
  • Phone: 301-715-3673
  • Fax: 888-496-8354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER KNOLL
Title or Position: ADMINISTRATIVE MANAGER
Credential:
Phone: 301-641-8678