# CORNERSTONE HEALTH & WELLNESS CLINIC OF TENNESSEE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144157223
- **Authorized official:** ANGELICA LUCAS LMSW (CEO/OWNER)
- **Authorized official phone:** (901) 406-6705

## Contact information

- **Practice address:** 10634 THREE WISHES DR, OLIVE BRANCH, MS 38654-8753
- **Practice address phone:** (901) 406-6705
- **Mailing address:** 10634 THREE WISHES DR, OLIVE BRANCH, MS 38654-8753
- **Mailing address phone:** (901) 406-6705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/05/2026
- **Last updated:** 05/05/2026