| Cornerstone Wellness Center Llc | |
|
1523 S Bluff Blvd Clinton IA 52732-6549 | |
| (563) 243-6054 | |
| (563) 243-6828 |
| Full Name | Cornerstone Wellness Center Llc |
|---|---|
| Speciality | Counselor |
| Location | 1523 S Bluff Blvd, Clinton, Iowa |
| Authorized Official Name and Position | Thomas Lee Millard (PSYCHOLOGIST) |
| Authorized Official Contact | 5632436054 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Wellness Center Llc 1523 S Bluff Blvd Clinton IA 52732-6549 Ph: (563) 243-6054 | Cornerstone Wellness Center Llc 1523 S Bluff Blvd Clinton IA 52732-6549 Ph: (563) 243-6054 |
| NPI Number | 1730292996 |
|---|---|
| Provider Enumeration Date | 08/15/2006 |
| Last Update Date | 09/20/2011 |
| Medicare PECOS PAC ID | 1052380813 |
|---|---|
| Medicare Enrollment ID | O20040928001119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730292996 | NPI | - | NPPES |
| 23379 | Other | IA | BLUE CROSS BLUE SHIELD |
| Provider Name | Gloria J Rumph |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295839223 PECOS PAC ID: 9335118025 Enrollment ID: I20040929000725 |
| Provider Name | Thomas L Millard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003929274 PECOS PAC ID: 9638148133 Enrollment ID: I20051021000361 |
| Provider Name | Rosemary Hanifan Jordan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093798589 PECOS PAC ID: 3577571397 Enrollment ID: I20081117000248 |
| Provider Name | Sean G Debourcy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972632768 PECOS PAC ID: 3173685203 Enrollment ID: I20081223000444 |
| Provider Name | Stephen D Harrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649221508 PECOS PAC ID: 7113967761 Enrollment ID: I20100429001131 |
| Provider Name | Michael C Mills |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891988671 PECOS PAC ID: 6305061011 Enrollment ID: I20140711001838 |
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