Provider Demographics
NPI:1114786621
Name:CORNERSTONE FAMILY THERAPY CENTER INC
Entity Type:Organization
Organization Name:CORNERSTONE FAMILY THERAPY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:574-310-2410
Mailing Address - Street 1:1415 LINCOLNWAY W STE Q
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46561-2063
Mailing Address - Country:US
Mailing Address - Phone:574-310-2410
Mailing Address - Fax:574-281-4412
Practice Address - Street 1:1415 LINCOLNWAY W STE Q
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IN
Practice Address - Zip Code:46561-2063
Practice Address - Country:US
Practice Address - Phone:574-651-8912
Practice Address - Fax:574-281-4412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty