Healthcare Provider Details

I. General information

NPI: 1174048995
Provider Name (Legal Business Name): CORNERSTONE COUNSELING AND CONSULTATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2017
Last Update Date: 11/10/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 E COLBY ST
WHITEHALL MI
49461-1113
US

IV. Provider business mailing address

516 E COLBY ST
WHITEHALL MI
49461-1113
US

V. Phone/Fax

Practice location:
  • Phone: 231-893-8336
  • Fax: 231-981-5277
Mailing address:
  • Phone: 231-893-8336
  • Fax: 231-981-5277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401009527
License Number StateMI

VIII. Authorized Official

Name: MR. JAMES L KOLBE
Title or Position: DIRECTOR/COUNSELOR
Credential: LLP, LPC
Phone: 231-893-8336