Organization
CORNERSTONE MENTAL HEALTH ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L. EASTIN CL/CO PSYCHOLOGIST ( (CO-OWNER/PARTNER)
(608) 271-9986
Entity
Organization
Contact information
Practice address
6417 ODANA RD, #C, MADISON, WI 53719
(608) 271-9986
(608) 271-9988
Mailing address
6417 ODANA RD, #C, MADISON, WI 53719
(608) 271-9986
(608) 271-9988
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1477
WI
1041C0700X
Clinical Social Worker
Primary
1780-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39210200
—
WI
Enumeration date
10/16/2009
Last updated
10/16/2009
Update your record
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