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General NPI Number Information
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NPI Number | 1194437830
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Entity Type | Organization
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Legal Business Name | COREHEALTHPSYCH
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 4807 BAYONNE AVE APT C
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City | BALTIMORE
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State | MD
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Zip | 21206-7622
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Country | US
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Telephone | 866-932-7654
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Fax | 470-826-1824
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Provider Business Mailing Address
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Address Line | 2131 KINGSTON CT SE STE 112
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City | MARIETTA
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State | GA
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Zip | 30067-8929
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Country | US
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Telephone | 866-932-7654
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AUGUSTA WILLIAMS
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Credential |
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Telephone | 866-932-7654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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