Provider Demographics
NPI:1801067012
Name:CORNERSTONE COUNSELING & CONSULTING, P.C,
Entity type:Organization
Organization Name:CORNERSTONE COUNSELING & CONSULTING, P.C,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:HECK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:260-387-6340
Mailing Address - Street 1:10315 DAWSONS CREEK BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1912
Mailing Address - Country:US
Mailing Address - Phone:260-387-6340
Mailing Address - Fax:
Practice Address - Street 1:10315 DAWSONS CREEK BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1912
Practice Address - Country:US
Practice Address - Phone:260-387-6340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5386103TC1900X
IN20041203A103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000175606OtherBLUE CROSS BLUE SHIELD
IN279625278002OtherMEDICAL MUTUAL OF OHIO
IN0007772138OtherAETNA
IN279625278002OtherMEDICAL MUTUAL OF OHIO
IN164750Medicare PIN