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NPI Code Detail

MEDICARE: CORNERSTONE COUNSELING CENTER

MEDICARE: CORNERSTONE COUNSELING CENTER
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1801348396
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORNERSTONE COUNSELING CENTER
Provider Business Mailing Address
First Line : 7007 S HONORE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60636-3213
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7007 S HONORE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60636-3213
Country : US
Telephone Number : 872-301-7540
Fax Number :
Authorized Official
Title or Position : CLINICAL EXTERN
Name : MS. KERRY REBECCA HURT
Credential :
Telephone Number : 872-301-7540
Provider Enumeration Date : 10/31/2016
Last Update Date : 10/31/2016

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Directions to “CORNERSTONE COUNSELING CENTER ” Practice Location

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