1063498459 NPI number — CORNERSTONE COUNSELING PC

Table of content: (NPI 1063498459)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063498459 NPI number — CORNERSTONE COUNSELING PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORNERSTONE COUNSELING PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
RAYMOND ARSENAULT PHD
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063498459
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/26/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH ANDOVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01845-2410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-985-4083
Provider Business Mailing Address Fax Number:
978-372-7563

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH ANDOVER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01845-2410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-985-4083
Provider Business Practice Location Address Fax Number:
978-372-7563
Provider Enumeration Date:
12/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ARSENAULT
Authorized Official First Name:
RAYMOND
Authorized Official Middle Name:
E
Authorized Official Title or Position:
EXECUTIVE DIRECTOR PRESIDENT
Authorized Official Telephone Number:
978-985-4083

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 613851 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 307470 . This is a "MANAGED HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: W10198 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 034281000 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: LMG015 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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