Organization
CORNERSTONE COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA JEAN JENKS C.A.D.C.III (A.O.D.A. COUNSLER)
(262) 542-3255
Entity
Organization
Contact information
Practice address
4811 S 76TH ST, GREENFIELD, WI 53220-4364
(414) 817-0442
(414) 817-0442
Mailing address
4811 S 76TH ST, GREENFIELD, WI 53220-4364
(414) 817-0442
(414) 817-0442
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
684
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39356400
—
WI
Enumeration date
08/22/2006
Last updated
08/08/2008
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