Provider Demographics
NPI:1821509688
Name:CORNERSTONE COUNSELING GROUP, LLC
Entity Type:Organization
Organization Name:CORNERSTONE COUNSELING GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:GRIFFITHS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:850-710-3306
Mailing Address - Street 1:PO BOX 5878
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-0878
Mailing Address - Country:US
Mailing Address - Phone:850-710-3306
Mailing Address - Fax:850-396-0920
Practice Address - Street 1:9466 NAVARRE PKWY STE C
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-2948
Practice Address - Country:US
Practice Address - Phone:850-710-3306
Practice Address - Fax:850-396-0920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-19
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15062261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health