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General NPI Number Information
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NPI Number | 1013375831
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Entity Type | Organization
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Legal Business Name | CORNERSTONE COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 02/08/2016
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Provider Practice Location Address
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Address Line | 111 E MIDLAND RD
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City | AUBURN
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State | MI
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Zip | 48611-9780
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Country | US
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Telephone | 989-266-3422
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Fax | 989-266-3197
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Provider Business Mailing Address
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Address Line | 111 E MIDLAND RD
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City | AUBURN
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State | MI
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Zip | 48611-9780
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Country | US
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Telephone | 989-266-3422
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Fax | 989-266-3197
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Authorized Official
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Title or Position | OWNER / AUTHORIZED OFFICIAL
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Name | REBECCA A WILSON-LONGLET
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Credential | LMSW
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Telephone | 989-266-3422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801071436
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License Number State | MI
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