| Cornerstone Wellness Center Pc | |
|
88 Faunce Corner Mall Rd Unit 230 Dartmouth MA 02747-1295 | |
| (508) 951-9802 | |
| (508) 300-0302 |
| Full Name | Cornerstone Wellness Center Pc |
|---|---|
| Speciality | Counselor |
| Location | 88 Faunce Corner Mall Rd Unit 230, Dartmouth, Massachusetts |
| Authorized Official Name and Position | Jonathan Joseph Lima Botelho (PRESIDENT/CEO AND THERAPIST) |
| Authorized Official Contact | 5089519802 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Wellness Center Pc 88 Faunce Corner Mall Rd Unit 230 Dartmouth MA 02747-1295 Ph: (508) 951-9802 | Cornerstone Wellness Center Pc 88 Faunce Corner Mall Rd Unit 230 Dartmouth MA 02747-1295 Ph: (508) 951-9802 |
| NPI Number | 1285418681 |
|---|---|
| Provider Enumeration Date | 08/24/2023 |
| Last Update Date | 08/24/2023 |
| Certification Date | 08/24/2023 |
| Medicare PECOS PAC ID | 2163873704 |
|---|---|
| Medicare Enrollment ID | O20240109000989 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285418681 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Claire M Olivier |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1508892456 PECOS PAC ID: 4284683053 Enrollment ID: I20050119000420 |
| Provider Name | Barbara B Kaplan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831278050 PECOS PAC ID: 6305862327 Enrollment ID: I20051019000739 |
| Provider Name | Lisa L Bradley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487962577 PECOS PAC ID: 8527295153 Enrollment ID: I20150106001661 |
| Provider Name | Jackeline Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356051130 PECOS PAC ID: 3678947165 Enrollment ID: I20230323003123 |
| Provider Name | Princewill Fonta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710612239 PECOS PAC ID: 0648644831 Enrollment ID: I20230330001886 |
| Provider Name | Jonathan Joseph Lima Botelho |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083937197 PECOS PAC ID: 3072964618 Enrollment ID: I20240113000674 |
| Provider Name | Wedline Rho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528837127 PECOS PAC ID: 8820324619 Enrollment ID: I20240130000930 |
| Provider Name | Veronica L Fitzgerald |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174898043 PECOS PAC ID: 3779925565 Enrollment ID: I20240524001114 |
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