Provider Demographics
NPI:1770649550
Name:CORNERSTONE FAMILY COUNSELING, P.C.
Entity Type:Organization
Organization Name:CORNERSTONE FAMILY COUNSELING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEPRENGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-591-2551
Mailing Address - Street 1:10372 DEMOCRACY LN
Mailing Address - Street 2:B
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2522
Mailing Address - Country:US
Mailing Address - Phone:703-591-2551
Mailing Address - Fax:703-591-2563
Practice Address - Street 1:10372 DEMOCRACY LN
Practice Address - Street 2:B
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2522
Practice Address - Country:US
Practice Address - Phone:703-591-2551
Practice Address - Fax:703-591-2563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA383091OtherGROUP PROVIDER # ANTHEM
VA145835OtherGROUP PROVIDER # ANTHEM
VA145835OtherGROUP PROVIDER #- ANTHEM