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General NPI Number Information
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NPI Number | 1780008599
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Entity Type | Organization
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Legal Business Name | CORNERSTONE COUNSELING OF PALM BEACH, PA
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Dates
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Enumeration Date | 02/13/2014
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Last Update Date | 05/18/2015
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Provider Practice Location Address
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Address Line | 1201 US HIGHWAY 1 SUITE 225
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City | NORTH PALM BEACH
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State | FL
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Zip | 33408-3550
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Country | US
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Telephone | 561-459-0621
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Fax | 561-290-1803
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Provider Business Mailing Address
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Address Line | 1201 US HIGHWAY 1 SUITE 225
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City | NORTH PALM BEACH
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State | FL
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Zip | 33408-3550
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Country | US
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Telephone | 561-459-0621
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Fax | 561-290-1803
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. JUSTIN H MCMANUS
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Credential | L.C.S.W.
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Telephone | 561-459-0621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW8168
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License Number State | FL
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