=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548110059
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CORNERSTONE THERAPY GROUP, A MARRIAGE AND FAMILY THERAPY CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/03/2026
-----------------------------------------------------
Last Update Date | 02/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15233 VENTURA BLVD STE 316
-----------------------------------------------------
City | SHERMAN OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91403-2214
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-508-6727
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15233 VENTURA BLVD STE 316
-----------------------------------------------------
City | SHERMAN OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91403-2214
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-508-6727
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT / CEO
-----------------------------------------------------
Name | ALAN ELLSWEIG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 310-508-6727
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------