Olivia Chance, LCSW, LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

91 Auburn St Ste J
Portland, ME 04103-6014

Phone

(207) 650-6670

NPI assigned

Oct 13, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Nikki Wetherell Counseling

  dba Virago Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, ME
  • NPI 1700358314
  NPD (past)

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616198400000",
    "number": "1124626197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 AUBURN ST STE J",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041036014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 AUBURN ST STE J",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041036014",
            "telephone_number": "207-650-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANCE",
        "first_name": "OLIVIA",
        "credential": "LCSW, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2021-03-20",
        "certification_date": "2021-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC7422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Chaloner
• Janice Chamberland, RN
• Karissa Chambers
• Leah Champagne, L.M.T
• John T Chance, M.D.
• Tejasvita Chandel
• Camden Chandler
• Amy Chaney, LMT
• Bright Jesuk Chang, DMD, MS
• Armin Changizi

• Clinical Social Worker in Portland, ME
• Providers in Portland, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.