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General NPI Number Information
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NPI Number | 1588312557
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Entity Type | Organization
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Legal Business Name | CORNERSTONE COUNSELING, LLC
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 600 N THACKER AVE
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City | KISSIMMEE
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State | FL
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Zip | 34741-4892
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Country | US
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Telephone | 321-732-2315
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Fax |
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Provider Business Mailing Address
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Address Line | 600 N THACKER AVE STE D31
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City | KISSIMMEE
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State | FL
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Zip | 34741-4808
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Country | US
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Telephone | 321-732-2315
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Fax | 321-222-6228
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Authorized Official
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Title or Position | MANAGER
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Name | GRIMARIE FERNANDEZ
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Credential | LMHC
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Telephone | 407-255-9504
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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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