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Contact Information

CHIQUITHA CORNELIUS
3130 S 11TH ST STE 105
NILES, MI49120-4736
 Phone: 574-274-0152
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Health

251E00000X A4[11] Home Health Agency
 

Adult Companion

372600000X
 

Chore Provider

372500000X
 

Cognitive & Behavioral

103TB0200X 62 Psychologist, Clinical
 

Group Psychotherapy

103TP2701X 62 Psychologist, Clinical
 

Home Health Aide

374U00000X
 

In Home Supportive Care

253Z00000X
 

Intellectual & Developmental Disabilities

103TM1800X 62 Psychologist, Clinical
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Psychoanalysis

103TP0814X 62 Psychologist, Clinical
 

Psychoanalyst

102L00000X
 

Psychologist

103T00000X 62 Psychologist, Clinical
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for

NPI Number 1033499173
Entity Organization
Organization subpart 1 Not specified
Enumeration date 08/21/2011
Last updated 01/21/2021 - About 5 years ago
Identifiers
MI License # 6301015882
MI License # 6801095307
MI License # 6830101788
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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