| Cornerstone Lifeworks Llc | |
|
320 Osuna Rd Ne Ste H4 Albuquerque NM 87107-5955 | |
| (505) 345-2778 | |
| Not Available |
| Full Name | Cornerstone Lifeworks Llc |
|---|---|
| Speciality | Counselor |
| Location | 320 Osuna Rd Ne Ste H4, Albuquerque, New Mexico |
| Authorized Official Name and Position | Sam Newmon (OWNER/CLINICAL SUPERVISOR) |
| Authorized Official Contact | 5053503027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Lifeworks Llc 320 Osuna Rd Ne Ste H4 Albuquerque NM 87107-5955 Ph: (505) 345-2778 | Cornerstone Lifeworks Llc 320 Osuna Rd Ne Ste H4 Albuquerque NM 87107-5955 Ph: (505) 345-2778 |
| NPI Number | 1841837119 |
|---|---|
| Provider Enumeration Date | 12/05/2019 |
| Last Update Date | 06/11/2024 |
| Certification Date | 06/11/2024 |
| Medicare PECOS PAC ID | 5698219111 |
|---|---|
| Medicare Enrollment ID | O20240626000081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841837119 | NPI | - | NPPES |
| 0171811 | Other | NM | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Sam Newmon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225337157 PECOS PAC ID: 0042754566 Enrollment ID: I20240626000154 |
| Provider Name | Wendy Taryn Deluca |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144565359 PECOS PAC ID: 4880138312 Enrollment ID: I20240626000370 |
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