Healthcare Provider Details

I. General information

NPI: 1093347346
Provider Name (Legal Business Name): CORNERSTONE COUNSELORS MENTAL HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 02/05/2020
Certification Date: 02/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 WALT WHITMAN RD STE 301
S HUNTINGTON NY
11746-3642
US

IV. Provider business mailing address

57 SOUTHDOWN RD
HUNTINGTON NY
11743-2551
US

V. Phone/Fax

Practice location:
  • Phone: 631-803-8808
  • Fax: 631-803-8808
Mailing address:
  • Phone: 631-673-3027
  • Fax: 631-910-0363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID B SCHULMAN
Title or Position: CLINICAL TEAM DIRECTOR
Credential: LMHC
Phone: 631-673-3027