NPIMap

Organization Active NPI

Cornerstone Psychological Services, PA

  • Mental Health Counselor
  • Greensboro, NC
National Provider Identifier
1174578652
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC0005 Issued in NC
Legal business name
CORNERSTONE PSYCHOLOGICAL SERVICES, PA
Practice address
2711 Pinedale Road
Suite a
Greensboro, NC 27408
Phone
(336) 540-9400
NPI assigned
May 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. John L Holt, MA, LPC, LPANPI 1992814883
Title
Director
Phone
(336) 540-9400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC0005 NC Primary

Addresses

Primary practice location

2711 Pinedale Road
Suite a
Greensboro, NC 27408

Mailing address

2711A Pinedale Road
Suite a
Greensboro, NC 27408
Phone (336) 540-9400

Other identifiers 3

IdentifierTypeStateIssuer
016FAOtherNCBCBS
6005300MedicaidNC
D1668OtherNCMEDCOST

National Provider Directory

National Provider Directory

Locations

2711 Pinedale Rd
Ste A
Greensboro, NC 27408
Phone (336) 540-9400

Practitioners & affiliated clinicians

Practitioners 4

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": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174578652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711A PINEDALE ROAD",
            "address_2": "SUITE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27408",
            "telephone_number": "336-540-9400",
            "fax_number": "336-540-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 PINEDALE ROAD",
            "address_2": "SUITE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27408",
            "telephone_number": "336-540-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE PSYCHOLOGICAL SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-540-9400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, LPC, LPA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "PC0005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "016FA",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005300",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D1668",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.