Individual provider Active NPI

Anne Chamberlain Oliver, LPC

  • Professional Counselor
  • Newport News, VA
National Provider Identifier
1104407626
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701010423 Issued in 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
Last updated
Mar 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X VA
Mental Health Counselor 101YM0800X 0701010423 VA
Professional Counselor 101YP2500X 0701010423 VA Primary

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

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bachman@bravewithin.com
FHIR URL www.bravewithin.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240307002810 VA Practitioner - Mental Health Counselor 5698111094 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701010423VAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Within Counseling LLC Professional CurrentSince Jun 18, 2024 Accepting new patients
New River Valley Community Services CurrentSince Jan 1, 2024 Accepting new patients
New River Valley Community Services CurrentSince Jan 1, 2024 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

Interoperability endpoints

  • Direct secure messaging: bachman@bravewithin.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1104407626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 LACON DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236082526",
            "telephone_number": "844-502-7283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11815 FOUNTAIN WAY STE 300-5409",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064448",
            "telephone_number": "844-502-7283",
            "fax_number": "757-517-0612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 University City Blvd",
            "address_purpose": "LOCATION",
            "city": "Blacksburg",
            "state": "VA",
            "postal_code": "240602706",
            "country_code": "US",
            "telephone_number": "540-961-8300",
            "fax_number": "540-961-8465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "ANNE",
        "middle_name": "CHAMBERLAIN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-16",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701010423",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701010423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bachman@bravewithin.com",
            "affiliation": "N",
            "address_1": "310 Hickory Dr",
            "city": "Christiansburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240735431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "www.bravewithin.com",
            "affiliation": "N",
            "address_1": "11815 Fountain Way Ste 300-5409",
            "city": "Newport News",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236064448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.