Provider Demographics
NPI:1275323230
Name:CHOLLMAN, CARLEY
Entity type:Individual
Prefix:
First Name:CARLEY
Middle Name:
Last Name:CHOLLMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5416 DORSEY ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37410-2029
Mailing Address - Country:US
Mailing Address - Phone:865-850-8565
Mailing Address - Fax:
Practice Address - Street 1:2433 BROAD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-2910
Practice Address - Country:US
Practice Address - Phone:865-850-8565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW0108451041C0700X
TN91201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical