Provider Demographics
NPI:1780008599
Name:CORNERSTONE COUNSELING OF PALM BEACH, PA
Entity Type:Organization
Organization Name:CORNERSTONE COUNSELING OF PALM BEACH, PA
Other - Org Name:JUSTIN H. MCMANUS, LCSW, PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCMANUS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-459-0621
Mailing Address - Street 1:1201 US HIGHWAY 1
Mailing Address - Street 2:SUITE 225
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3550
Mailing Address - Country:US
Mailing Address - Phone:561-459-0621
Mailing Address - Fax:561-290-1803
Practice Address - Street 1:1201 US HIGHWAY 1
Practice Address - Street 2:SUITE 225
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3550
Practice Address - Country:US
Practice Address - Phone:561-459-0621
Practice Address - Fax:561-290-1803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-13
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW81681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEU263ZOtherMEDICARE PROVIDER NUMBER