Provider Demographics
NPI:1033970728
Name:CORNERSTONE COUNSELING
Entity Type:Organization
Organization Name:CORNERSTONE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER /OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRIMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:321-732-2315
Mailing Address - Street 1:3010 BOAT LIFT RD FL 34746
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-4549
Mailing Address - Country:US
Mailing Address - Phone:407-255-9504
Mailing Address - Fax:
Practice Address - Street 1:600 N THACKER AVE STE D31
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4808
Practice Address - Country:US
Practice Address - Phone:321-732-2315
Practice Address - Fax:321-222-6228
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORNERSTONE COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty