| Cornerstone Psychological Services, Pa | |
|
2711 Pinedale Road Suite A Greensboro NC 27408 | |
| (336) 540-9400 | |
| Not Available |
| Full Name | Cornerstone Psychological Services, Pa |
|---|---|
| Speciality | Counselor |
| Location | 2711 Pinedale Road, Greensboro, North Carolina |
| Authorized Official Name and Position | John L Holt (DIRECTOR) |
| Authorized Official Contact | 3365409400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Psychological Services, Pa 2711a Pinedale Road Suite A Greensboro NC 27408 Ph: (336) 540-9400 | Cornerstone Psychological Services, Pa 2711 Pinedale Road Suite A Greensboro NC 27408 Ph: (336) 540-9400 |
| NPI Number | 1174578652 |
|---|---|
| Provider Enumeration Date | 05/23/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3274537139 |
|---|---|
| Medicare Enrollment ID | O20060907000064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174578652 | NPI | - | NPPES |
| D1668 | Other | NC | MEDCOST |
| 6005300 | Medicaid | NC | |
| 016FA | Other | NC | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | PC0005 (North Carolina) | Primary |
| Provider Name | Randy D Readling |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952361610 PECOS PAC ID: 9931110434 Enrollment ID: I20060517000005 |
| Provider Name | Mary S Olcott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033224266 PECOS PAC ID: 6800890385 Enrollment ID: I20060914000603 |
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