Provider Demographics
NPI:1922502608
Name:CORNERSTONE COUNSELING CENTER, PLLC
Entity type:Organization
Organization Name:CORNERSTONE COUNSELING CENTER, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:270-734-1220
Mailing Address - Street 1:4695 HARDINSBURG RD
Mailing Address - Street 2:
Mailing Address - City:CECILIA
Mailing Address - State:KY
Mailing Address - Zip Code:42724-9787
Mailing Address - Country:US
Mailing Address - Phone:270-205-4499
Mailing Address - Fax:270-282-7153
Practice Address - Street 1:4695 HARDINSBURG RD
Practice Address - Street 2:
Practice Address - City:CECILIA
Practice Address - State:KY
Practice Address - Zip Code:42724-9787
Practice Address - Country:US
Practice Address - Phone:270-862-4825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-19
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100563950Medicaid