NPIMap

Organization Active NPI

Cornerstone Psychological Affiliates

  • Group Psychotherapy Psychologist
  • Berlin, OH
National Provider Identifier
1124139928
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
Legal business name
CORNERSTONE PSYCHOLOGICAL AFFILIATES
Practice address
4585 State Route 39
Hummil BLDG
Berlin, OH 44610
Phone
(330) 893-8100
Fax
(330) 893-7209
NPI assigned
Aug 31, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John C Shultz, PHDNPI 1154358059
Title
President Owner
Phone
(419) 289-1876

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X Primary

Addresses

Primary practice location

4585 State Route 39
Hummil BLDG
Berlin, OH 44610

Mailing address

259 Sandusky St
Ashland, OH 44805
Phone (419) 289-1876

National Provider Directory

National Provider Directory
Tax ID family
Cornerstone Psychological Affiliates5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1124139928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 SANDUSKY ST",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "44805",
            "telephone_number": "419-289-1876",
            "fax_number": "419-281-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4585 STATE ROUTE 39",
            "address_2": "HUMMIL BLDG",
            "city": "BERLIN",
            "state": "OH",
            "postal_code": "44610",
            "telephone_number": "330-893-8100",
            "fax_number": "330-893-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE PSYCHOLOGICAL AFFILIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "SHULTZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT  OWNER",
        "authorized_official_telephone_number": "419-289-1876",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.