=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720103096
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CORNERSTONECONSULTING AND ASSESSMENTS,
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/19/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 732 EDEN WAY N STE E
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23320-2798
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-375-2220
-----------------------------------------------------
Fax | 757-523-1360
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 732 EDEN WAY N STE E
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23320-2798
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-375-2220
-----------------------------------------------------
Fax | 757-523-1360
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ROSALEE L YOUNG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 757-592-5545
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------