Provider Demographics
NPI:1780308684
Name:CORNERSTONE COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:CORNERSTONE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TASHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-391-3774
Mailing Address - Street 1:478 WASHINGTON ST APT 403
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-2491
Mailing Address - Country:US
Mailing Address - Phone:973-391-3774
Mailing Address - Fax:
Practice Address - Street 1:478 WASHINGTON ST APT 403
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-2491
Practice Address - Country:US
Practice Address - Phone:973-391-3774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty