MEDICARE: CORE BRAIN HEALTH

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1356209845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE BRAIN HEALTH

Provider Business Mailing Address
First Line	:	10608 FLICKENGER LN
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-3485
Country	:	US
Telephone Number	:	423-948-9331
Fax Number	:

Provider Business Practice Location Address
First Line	:	10608 FLICKENGER LN
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-3485
Country	:	US
Telephone Number	:	423-948-9331
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KATHRYN WALKER
Credential	:	CRNA, PMHNP
Telephone Number	:	423-948-9331

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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