NPIMap

Organization Active NPI

Cornerstone Counseling and Wellness, LLC

Doing business as Cornerstone Therapy and Wellness

  • Mental Health Counselor
  • Malvern, PA
National Provider Identifier
1750713889
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CW014460 Issued in PA
Legal business name
CORNERSTONE COUNSELING AND WELLNESS, LLC
Doing business as
Cornerstone Therapy and Wellness
Practice address
639 Swedesford Rd
Malvern, PA 19355-1530
Phone
(610) 616-5935
NPI assigned
Jul 31, 2013
Last updated
Jan 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Authorized official

Name
Staci ConnollyNPI 1649319815
Title
Owner
Phone
(484) 645-0252

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 CW014460 PA Primary

Addresses

Primary practice location

639 Swedesford Rd
Malvern, PA 19355-1530

Mailing address

639 Swedesford Rd
Malvern, PA 19355-1530
Phone (610) 616-5935

Other practice location 1

435 Devon Park Dr Ste 300
Wayne, PA 19087-1943
Phone (610) 616-5935

Other names 1

  • Cornerstone Therapy and Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240709001622 PA Part B Supplier - Clinic/Group Practice 9133664626 Receives reassigned benefits from 14 practitioners
Practice locations: Malvern, PA

National Provider Directory

National Provider Directory

Locations

1 N Bacton Hill Rd
Ste 107
Malvern, PA 19355
Phone (610) 529-1579

639 Swedesford Rd
Malvern, PA 19355
Phone (610) 529-1579

435 Devon Park Dr
Ste 300
Wayne, PA 19087
Phone (610) 616-5935

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1750713889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 SWEDESFORD RD",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551530",
            "telephone_number": "610-616-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 SWEDESFORD RD",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551530",
            "telephone_number": "610-616-5935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Devon Park Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Wayne",
            "state": "PA",
            "postal_code": "190871943",
            "country_code": "US",
            "telephone_number": "610-616-5935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CORNERSTONE COUNSELING AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-31",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "CONNOLLY",
        "authorized_official_first_name": "STACI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "484-645-0252"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "CW014460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Therapy and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Malvern, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.