MEDICARE: CARLEY CHOLLMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	MSW010845	GA
2	1041C0700X	Clinical Social Worker	9120	TN

General Provider Information

NPI Number	:	1275323230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLEY CHOLLMAN

Provider Business Mailing Address
First Line	:	5416 DORSEY ST
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37410-2029
Country	:	US
Telephone Number	:	865-850-8565
Fax Number	:

Provider Business Practice Location Address
First Line	:	2433 BROAD ST
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37408-2910
Country	:	US
Telephone Number	:	865-850-8565
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2025
Last Update Date	:	05/12/2025

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Directions to “ CARLEY CHOLLMAN ” Practice Location

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