Cornerstone Restoration and Training Services

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

0904006909 Issued in VA

Legal business name

CORNERSTONE RESTORATION AND TRAINING SERVICES

Practice address

1700 Blair St
Richmond, VA 23220-6406

Phone

(804) 852-7645

NPI assigned

Jun 9, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Ellis O. Henderson, ED.D, M.DIV

Title

Owner

Phone

(804) 852-7645

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1720517923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 WISTAR RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232282640",
            "telephone_number": "804-852-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 BLAIR ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232206406",
            "telephone_number": "804-852-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE RESTORATION AND TRAINING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-09",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "ELLIS",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-852-7645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D, M.DIV"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "VA",
            "license": "0904006909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fritznel Corneille Jr.
• Bianca Jenay Cornelius, LPC
• Julia Alexandra Cornelius
• Victoria Mari Cornelius, NP
• Alexandra G Cornell, LCSW
• Cornerstone Youth Services, LLC
• Micaela Cornis-Pop, PHD, CCC-SLP
• Edmund W Cornman, MD
• Marie B Cornwall, NP
• Jennifer Renee Cornwell, FNP-C

• Mental Health Clinic/Center (Including Community Mental Health Center) in Richmond, VA
• Providers in Richmond, VA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.