Organization
CORNERSTONE COUNSELING & CONSULTING SPECIALISTS LLC
Active
Parent organization
CORNERSTONE COUNSELING & CONSULTING SPECIALISTS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CORNERSTONE COUNSELING & CONSULTING SPECIALISTS LLC
Authorized official
MS. MARIE COLETTE GRAY PHD; NCP; LPC; FAAGB (CEO/OWNER)
(570) 674-1505
Entity
Organization
Contact information
Practice address
1172 TWIN STACKS DR, DALLAS, PA 18612-8505
(570) 674-1505
(570) 674-8679
Mailing address
1172 TWIN STACKS DRIVE, DALLAS, PA 18612-9178
(570) 674-1505
(570) 674-8679
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PC-003840
PA
101YP2500X
Professional Counselor
Primary
PC003840
PA
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
PS005483L
PA
103TC2200X
Clinical Child & Adolescent Psychologist
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023152530001
DPW
PA
05
—
1023152530002
—
PA
05
—
1033152530002
—
PA
Enumeration date
01/16/2009
Last updated
10/05/2015
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