Cornerstone Wellness Group, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

12361 Issued in TX

Legal business name

CORNERSTONE WELLNESS GROUP, LLC

Practice address

405 E. Crockett St.
Cleveland, TX 77327-9998

Phone

(281) 593-1888

Fax

(281) 593-1890

NPI assigned

Apr 28, 2014

Last updated

Apr 28, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lois Marie Liddle, LPC-S

Title

Licensed Proffesional Counselor

Phone

(281) 593-1888

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398643200000",
    "number": "1407266604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 E. CROCKETT ST.",
            "city": "CLEVELAND",
            "state": "TX",
            "postal_code": "773279998",
            "telephone_number": "281-593-1888",
            "fax_number": "281-593-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 E. CROCKETT ST.",
            "city": "CLEVELAND",
            "state": "TX",
            "postal_code": "773279998",
            "telephone_number": "281-593-1888",
            "fax_number": "281-593-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE WELLNESS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-28",
        "last_updated": "2014-04-28",
        "status": "A",
        "authorized_official_last_name": "LIDDLE",
        "authorized_official_first_name": "LOIS",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "LICENSED PROFFESIONAL COUNSELOR",
        "authorized_official_telephone_number": "281-593-1888",
        "authorized_official_credential": "LPC-S"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "12361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255688297",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.