Provider Demographics
NPI:1841837119
Name:CORNERSTONE LIFEWORKS LLC
Entity type:Organization
Organization Name:CORNERSTONE LIFEWORKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-350-3027
Mailing Address - Street 1:320 OSUNA RD NE STE H4
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-5955
Mailing Address - Country:US
Mailing Address - Phone:505-345-2778
Mailing Address - Fax:
Practice Address - Street 1:320 OSUNA RD NE STE H4
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-5955
Practice Address - Country:US
Practice Address - Phone:505-345-2778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM0171811OtherLICENSE NUMBER