Healthcare Provider Details

I. General information

NPI: 1588381776
Provider Name (Legal Business Name): CORNERSTONE COUNSELING AND COACHING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10310 N 138TH EAST AVE STE 101
OWASSO OK
74055-4611
US

IV. Provider business mailing address

10310 N 138TH EAST AVE STE 101
OWASSO OK
74055-4611
US

V. Phone/Fax

Practice location:
  • Phone: 918-927-3110
  • Fax:
Mailing address:
  • Phone: 918-927-3110
  • Fax:

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: MICHELLE WHITEMAN
Title or Position: OWNER
Credential:
Phone: 918-927-3110