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Contact Information

CHMG CORELIFE, LLC
1036 SAINT NICHOLAS DR UNIT 101
WALDORF, MD20603-4758
 Phone: 240-261-7170
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Bariatric Medicine

2084B0002X 86 Physician/Neuropsychiatry
 

Mental Health

101YM0800X
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for CHMG CORELIFE, LLC

NPI # 1316654460
LBN Legal business name CHMG CORELIFE, LLC
Authorized official CAROLYN HEITHAUS - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 10/28/2022
Last updated 01/16/2024 - About 2 years ago
Identifiers n/a
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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