Anne Chamberlain Oliver, LPC
Individual provider Active NPI Professional Counselor · Newport News, VA
NPI 1104407626 · NPPES record last updated Mar 7, 2024
Key facts
- NPI
- 1104407626
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 0701010423 (VA)
- Practice address
- 11815 Fountain Way Ste 300-5409
Newport News, VA 23606-4448 - Phone
- (844) 502-7283
- Fax
- (757) 517-0612
- NPI assigned
- Apr 16, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240307002810 | VA | Practitioner - Mental Health Counselor | 5698111094 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701010423 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brave Within Counseling LLC | Professional | Current |
Accepting new patients |
| New River Valley Community Services | Current |
Accepting new patients | |
| New River Valley Community Services | Current |
Accepting new patients |
Locations
700 University City Blvd
Blacksburg, VA 24060
Phone (540) 961-8300
11815 Fountain Way
Ste 300
Newport News, VA 23606
Phone (757) 505-7574
705 Wenonah Ave
Pearisburg, VA 24134
Phone (540) 921-2238
401 W Main St
Radford, VA 24141
Phone (540) 838-8000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | VA | ||
| Mental Health Counselor | 101YM0800X | 0701010423 | VA | |
| Professional Counselor | 101YP2500X | 0701010423 | VA | Yes |
Addresses
Primary practice location
11815 Fountain Way Ste 300-5409
Newport News, VA 23606-4448
Mailing address
969 Lacon Dr
Newport News, VA 23608-2526
Phone (844) 502-7283
Other practice location 1
700 University City Blvd
Blacksburg, VA 24060-2706
Phone (540) 961-8300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0701010423 | Other | VA | LICENSE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bachman@bravewithin.com | ||
| FHIR URL | www.bravewithin.com |
Other providers in Newport News, VA
- Oyejoke Temilola Olaoye-Adejayan
- Old Dominion Rehabilitation and Nursing LLC
- William L Old III
- Cameron Lauritz Oldham
- Stephen Olesko
- Celeste Ollieu
- Scott E. Olney
- Myah Marie Olson
- Muhammad Omer
- On Call Psychiatry
All providers in Newport News, VA · Professional Counselor in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.