Healthcare Provider Details

I. General information

NPI: 1437228905
Provider Name (Legal Business Name): CORNERSTONE COUNSELING AND CONSULTING, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 E SUNSHINE ST SUITE 212
SPRINGFIELD MO
65804-1924
US

IV. Provider business mailing address

2200 E SUNSHINE ST SUITE 212
SPRINGFIELD MO
65804-1924
US

V. Phone/Fax

Practice location:
  • Phone: 417-888-3012
  • Fax: 417-885-9012
Mailing address:
  • Phone: 417-888-3012
  • Fax: 417-885-9012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number006050
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1999140252
License Number StateMO

VIII. Authorized Official

Name: DR. STEVEN B. ADAMS
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 417-888-3012