Healthcare Provider Details

I. General information

NPI: 1932054947
Provider Name (Legal Business Name): CORE BEHAVIORAL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 WICKWOOD DR
CHESAPEAKE VA
23322-5853
US

IV. Provider business mailing address

504 WICKWOOD DR
CHESAPEAKE VA
23322-5853
US

V. Phone/Fax

Practice location:
  • Phone: 757-997-5315
  • Fax: 757-997-5315
Mailing address:
  • Phone: 757-997-5315
  • Fax: 757-997-5315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CANDICE HARRIS
Title or Position: CEO
Credential:
Phone: 757-997-5315