MEDICARE: CORE BEHAVIORAL SOLUTIONS LLC

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
2	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1932054947
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE BEHAVIORAL SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	504 WICKWOOD DR
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23322-5853
Country	:	US
Telephone Number	:	757-997-5315
Fax Number	:	757-997-5315

Provider Business Practice Location Address
First Line	:	504 WICKWOOD DR
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23322-5853
Country	:	US
Telephone Number	:	757-997-5315
Fax Number	:	757-997-5315

Authorized Official
Title or Position	:	CEO
Name	:	CANDICE HARRIS
Credential	:
Telephone Number	:	757-997-5315

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/15/2026

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