Provider Demographics
NPI:1225327141
Name:UNITED CHURCH OF CHRIST OF ANNAPOLIS/CORNERSTONE COUNSELING CTR.
Entity Type:Organization
Organization Name:UNITED CHURCH OF CHRIST OF ANNAPOLIS/CORNERSTONE COUNSELING CTR.
Other - Org Name:CORNERSTONE PASTORAL CARE & COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:PEHLE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:301-466-1713
Mailing Address - Street 1:8 CARVEL CIRCLE
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037
Mailing Address - Country:US
Mailing Address - Phone:410-266-8596
Mailing Address - Fax:410-266-9740
Practice Address - Street 1:8 CARVEL CIR
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-1005
Practice Address - Country:US
Practice Address - Phone:410-266-8596
Practice Address - Fax:410-266-9740
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED CHURCH OF CHRIST OF ANNAPOLIS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty