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General NPI Number Information
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NPI Number | 1124139928
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Entity Type | Organization
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Legal Business Name | CORNERSTONE PSYCHOLOGICAL AFFILIATES
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4585 STATE ROUTE 39 HUMMIL BLDG
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City | BERLIN
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State | OH
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Zip | 44610
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Country | US
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Telephone | 330-893-8100
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Fax | 330-893-7209
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Provider Business Mailing Address
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Address Line | 259 SANDUSKY ST
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City | ASHLAND
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State | OH
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Zip | 44805
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Country | US
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Telephone | 419-289-1876
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Fax | 419-281-6430
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | JOHN C SHULTZ
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Credential | PHD
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Telephone | 419-289-1876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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