Provider Demographics
NPI:1568770402
Name:CORNERSTONE CHRISTIAN COUNSELING
Entity Type:Organization
Organization Name:CORNERSTONE CHRISTIAN COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:606-638-0222
Mailing Address - Street 1:203 SOUTH WATER STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOUISA
Mailing Address - State:KY
Mailing Address - Zip Code:41230
Mailing Address - Country:US
Mailing Address - Phone:606-638-0222
Mailing Address - Fax:
Practice Address - Street 1:203 SOUTH WATER STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230
Practice Address - Country:US
Practice Address - Phone:606-638-0222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12606101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty