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Organization

CORNERSTONE PSYCHIATRIC SERVICES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRAD LABATH (OFFICE MANAGER)
(941) 488-8884
Entity
Organization

Contact information

Practice address
1790 E VENICE AVE, SUITE 204, VENICE, FL 34292-3191
(941) 488-8884
(941) 488-5554
Mailing address
1790 E VENICE AVE, SUITE 204, VENICE, FL 34292-3191
(941) 488-8884
(941) 488-5554

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2084P0800X
Psychiatry Physician
Primary
OS8175
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
ARNP1799382
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
270064600
FL
01
557401-000
MAGELLAN
FL
01
7384438
AETNA
FL
01
DA7120
RAILROAD MEDICARE
FL
Enumeration date
09/23/2005
Last updated
11/10/2025
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