Healthcare Provider Details

I. General information

NPI: 1942122445
Provider Name (Legal Business Name): CORNERSTONE COUNSELING AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 W CROCUS DR
GLENDALE AZ
85306-4137
US

IV. Provider business mailing address

6040 W CROCUS DR
GLENDALE AZ
85306-4137
US

V. Phone/Fax

Practice location:
  • Phone: 623-640-3105
  • Fax:
Mailing address:
  • Phone: 623-640-3105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. THEMBANI TIMOTHY HLAZO-THREADGILL
Title or Position: MANAGING PARTNER
Credential: LPC
Phone: 623-640-3105