Organization
CORNERSTONE COUNSELING CENTER, INC.
Active
Organization
CORNERSTONE COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS GAMMELLO (ADMINISTRATOR)
(218) 828-1028
Entity
Organization
Contact information
Practice address
14275 GOLF COURSE DR., SUITE 160, BAXTER, MN 56425
(218) 828-1028
Mailing address
14275 GOLF COURSE DR., SUITE 160, BAXTER, MN 56425
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1437
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62Q98CO
BLUE CROSS
MN
Enumeration date
08/30/2006
Last updated
08/22/2020
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