MEDICARE: CORIENA MAXEY LLMSW

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	171M00000X	Case Manager/Care Coordinator	6851121599	MI

General Provider Information

NPI Number	:	1629878533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORIENA MAXEY LLMSW

Provider Business Mailing Address
First Line	:	2450 VAN OMMEN DR
Second Line	:
City	:	HOLLAND
State	:	MI
Zip	:	49424-8085
Country	:	US
Telephone Number	:	616-350-7781
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 VAN OMMEN DR
Second Line	:
City	:	HOLLAND
State	:	MI
Zip	:	49424-8085
Country	:	US
Telephone Number	:	616-350-7781
Fax Number	:

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

Provider Enumeration Date	:	03/18/2025
Last Update Date	:	05/14/2026

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