Provider Demographics
NPI:1851743108
Name:CORNERSTONE COUNSELING CENTER
Entity Type:Organization
Organization Name:CORNERSTONE COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:702-433-4357
Mailing Address - Street 1:5825 W SAHARA AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-3178
Mailing Address - Country:US
Mailing Address - Phone:702-433-4357
Mailing Address - Fax:702-222-1210
Practice Address - Street 1:5825 W SAHARA AVE
Practice Address - Street 2:SUITE K
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-3178
Practice Address - Country:US
Practice Address - Phone:702-433-4357
Practice Address - Fax:702-222-1210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2000443810251S00000X
NV2000057-517251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health