# CORNERSTONE WELLNESS CENTER LLC

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

## Provider details

- **NPI number:** 1730292996
- **Authorized official:** MR. THOMAS LEE MILLARD P.H.D (PSYCHOLOGIST)
- **Authorized official phone:** (563) 243-6054

## Contact information

- **Practice address:** 1523 S BLUFF BLVD, CLINTON, IA 52732-6549
- **Practice address phone:** (563) 243-6054
- **Practice address fax:** (563) 243-6828
- **Mailing address:** 1523 S BLUFF BLVD, CLINTON, IA 52732-6549
- **Mailing address phone:** (563) 243-6054
- **Mailing address fax:** (563) 243-6828

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 09/20/2011