Cornerstone Counseling & Consulting, P.C,
Organization Active NPI Counseling Psychologist · Fort Wayne, IN
NPI 1801067012 · NPPES record last updated Jan 14, 2016
Key facts
- NPI
- 1801067012
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Counseling Psychologist 103TC1900X
- License
- 20041203A (IN)
- Legal business name
- CORNERSTONE COUNSELING & CONSULTING, P.C,
- Practice address
- 10315 Dawsons Creek Blvd
Suite F
Fort Wayne, IN 46825-1912 - Phone
- (260) 387-6340
- NPI assigned
- Mar 14, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Robert Paul Heck, PH.D.
- Title
- President
- Phone
- (260) 387-6340
Practitioners 10
-
Robert Paul Heck, PH.D
-
Mary Lisa Barta, MS, LMFTA
-
Rebecca Sue Berghorn, LMFT
-
Kim Maxwell Fish, LCSW, LMHC
-
Lisa A. Heck, M.A.
-
Victoria Anne Lightcap, MS, LMFTA
-
Jennifer Renee Mertz-Turner, LMHC, MAC
-
Sharon S Miley, LMFT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OH, IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080422000284 | OH | Part B Supplier - Clinic/Group Practice | 9931287646 |
Receives reassigned benefits from 1 practitioner Practice locations: Paulding, OH |
| O20090225000311 | IN | Part B Supplier - Clinic/Group Practice | 9931287646 |
Receives reassigned benefits from 1 practitioner Practice locations: Fort Wayne, IN |
National Provider Directory
Locations
3948 New Vision Dr
Ste D
Fort Wayne, IN 46845
Phone (260) 245-1455
10315 Dawsons Creek Blvd
Ste F
Fort Wayne, IN 46825
Phone (260) 387-6340
1030 W Wayne St
Paulding, OH 45879
Phone (260) 387-6340
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist |
103TC1900X | 20041203A | IN | Yes |
| Counseling Psychologist |
103TC1900X | 5386 | OH |
Addresses
Primary practice location
10315 Dawsons Creek Blvd
Suite F
Fort Wayne, IN 46825-1912
Mailing address
10315 Dawsons Creek Blvd
Suite F
Fort Wayne, IN 46825-1912
Phone (260) 387-6340
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000175606 | Other | IN | BLUE CROSS BLUE SHIELD |
| 279625278002 | Other | IN | MEDICAL MUTUAL OF OHIO |
| 0007772138 | Other | IN | AETNA |
Other providers in Fort Wayne, IN
- Core Physical Therapy LLC
- Samuel Louis Corey II
- Samuel Louis Corey
- Elise Cormany
- Cornerstone Caregiving East LLC
- Justin Robert Cornewell
- Kimberly Paige Cornman
- Carissa Cornwall
- Pamela S Cornwell
- Gina Coronato
All providers in Fort Wayne, IN · Counseling Psychologist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.