Provider Demographics
NPI:1831493808
Name:CORNERSTONE COUNSELING, LLC
Entity Type:Organization
Organization Name:CORNERSTONE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LINK
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPCC
Authorized Official - Phone:505-326-5807
Mailing Address - Street 1:2600 FARMINGTON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-4507
Mailing Address - Country:US
Mailing Address - Phone:505-326-5807
Mailing Address - Fax:
Practice Address - Street 1:2600 FARMINGTON AVE STE B
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-4507
Practice Address - Country:US
Practice Address - Phone:505-326-5807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMNM 0766101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM95458573Medicaid