Provider Demographics
NPI:1568779577
Name:CORNERSTON MARRIAGE AND FAMILY COUNSELING SERVICES
Entity Type:Organization
Organization Name:CORNERSTON MARRIAGE AND FAMILY COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KARRYL
Authorized Official - Middle Name:J
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S, LICDC,SAP
Authorized Official - Phone:216-320-0440
Mailing Address - Street 1:2490 LEE BLVD
Mailing Address - Street 2:#307
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1268
Mailing Address - Country:US
Mailing Address - Phone:216-320-0440
Mailing Address - Fax:216-320-0442
Practice Address - Street 1:2490 LEE BLVD
Practice Address - Street 2:#307
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1268
Practice Address - Country:US
Practice Address - Phone:216-320-0440
Practice Address - Fax:216-320-0442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH872393101YA0400X
OHI0008328106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty