Healthcare Provider Details

I. General information

NPI: 1750188637
Provider Name (Legal Business Name): CARECORE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5023 ARBUTUS AVE
BALTIMORE MD
21215-5723
US

IV. Provider business mailing address

5023 ARBUTUS AVE
BALTIMORE MD
21215-5723
US

V. Phone/Fax

Practice location:
  • Phone: 248-678-2259
  • Fax:
Mailing address:
  • Phone: 248-678-2259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DAVID HARDY
Title or Position: CEO
Credential:
Phone: 281-599-0300