MEDICARE: CORNERSTONE COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1417887175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORNERSTONE COUNSELING LLC

Provider Business Mailing Address
First Line	:	1604 OTLAHURST DR
Second Line	:
City	:	FAIRMONT
State	:	WV
Zip	:	26554-2029
Country	:	US
Telephone Number	:	856-275-6645
Fax Number	:

Provider Business Practice Location Address
First Line	:	1604 OTLAHURST DR
Second Line	:
City	:	FAIRMONT
State	:	WV
Zip	:	26554-2029
Country	:	US
Telephone Number	:	856-275-6645
Fax Number	:

Authorized Official
Title or Position	:	MENTAL HEALTH THERAPIST
Name	:	SARAH STRADER
Credential	:	LPC
Telephone Number	:	856-275-6645

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	05/22/2026

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