NPIMap

Organization Active NPI

Cornerstone Counseling & Consulting Specialists LLC

  • Professional Counselor
  • Dallas, PA
National Provider Identifier
1245477975
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC003840 Issued in PA
Legal business name
CORNERSTONE COUNSELING & CONSULTING SPECIALISTS LLC
Practice address
1172 Twin Stacks Dr
Dallas, PA 18612-8505
Phone
(570) 674-1505
Fax
(570) 674-8679
NPI assigned
Jan 16, 2009
Last updated
Oct 5, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
CORNERSTONE COUNSELING & CONSULTING SPECIALISTS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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

Authorized official

Name
Ms. Marie Colette Gray, PHD; NCP; LPC; FAAGBNPI 1265679997
Title
Ceo/Owner
Phone
(570) 674-1505

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC003840 PA Primary
Professional Counselor 101YP2500X PC-003840 PA
Professional Counselor 101YP2500X NU
Clinical Psychologist 103TC0700X PS005483L PA
Clinical Child & Adolescent Psychologist 103TC2200X PA

Addresses

Primary practice location

1172 Twin Stacks Dr
Dallas, PA 18612-8505

Mailing address

1172 Twin Stacks Drive
Dallas, PA 18612-9178
Phone (570) 674-1505

Other identifiers 3

IdentifierTypeStateIssuer
1023152530001OtherPADPW
1023152530002MedicaidPA
1033152530002MedicaidPA

National Provider Directory

National Provider Directory
Part of
Cornerstone Counseling Con

Locations

1172 Twin Stacks Dr
Dallas, PA 18612
Phone (570) 674-1505

Practitioners & affiliated clinicians

Practitioners 8

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": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444003200000",
    "number": "1245477975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1172 TWIN STACKS DRIVE",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186129178",
            "telephone_number": "570-674-1505",
            "fax_number": "570-674-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1172 TWIN STACKS DR",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186128505",
            "telephone_number": "570-674-1505",
            "fax_number": "570-674-8679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE COUNSELING & CONSULTING SPECIALISTS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORNERSTONE COUNSELING & CONSULTING SPECIALISTS LLC",
        "enumeration_date": "2009-01-16",
        "last_updated": "2015-10-05",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "COLETTE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "570-674-1505",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHD; NCP; LPC; FAAGB"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC003840",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC-003840",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS005483L",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPW",
            "identifier": "1023152530001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023152530002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033152530002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; 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.