Healthcare Provider Details

I. General information

NPI: 1790944908
Provider Name (Legal Business Name): ROSEMARY P MCDONAGH PMHCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 03/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 WEST LIBERTY CORNERSTONE PSYCHOLOGICAL & COUNSELING SERVICES
MEDINA OH
44256
US

IV. Provider business mailing address

221 WEST LIBERTY ST CORNERSTONE PSYCHOLOGICAL AND COUNSELING SERVICES
MEDINA OH
44256
US

V. Phone/Fax

Practice location:
  • Phone: 330-722-4166
  • Fax:
Mailing address:
  • Phone: 330-722-4166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberNS-05203
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberCTP#RX05203
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-272863
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: