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General NPI Number Information
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NPI Number | 1275656399
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Entity Type | Organization
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Legal Business Name | CORNERSTONE FAMILY COUNSELING,INC.
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1115 BETHEL RD
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City | COLUMBUS
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State | OH
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Zip | 43220-2690
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Country | US
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Telephone | 614-459-3003
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Fax | 614-451-3017
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Provider Business Mailing Address
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Address Line | 1115 BETHEL RD
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City | COLUMBUS
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State | OH
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Zip | 43220-2690
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Country | US
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Telephone | 614-459-3003
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Fax | 614-451-3017
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Authorized Official
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Title or Position | CEO
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Name | DR. KENNETH A. BEAVERS
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Credential | PH.D.
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Telephone | 614-459-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4271
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License Number State | OH
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