Charlotte Vancleve, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201909205NP-PP Issued in OR

Practice address

1312 SW Washington St
Portland, OR 97205-2327

Phone

(503) 535-1150

Fax

(503) 535-1192

NPI assigned

Mar 9, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Fora Health Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
  • NPI 1245378546

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD (past)
• Fora Health Inc.

  • Substance Abuse Rehabilitation Facility
  • Portland, OR
  • NPI 1033968193
  NPD (past)

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1669865168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 SW WASHINGTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 SW WASHINGTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052327",
            "telephone_number": "503-535-1150",
            "fax_number": "503-535-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCLEVE",
        "first_name": "CHARLOTTE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-09",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201909205NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cammi Vance, DC, LMT
• Julia M Vance, MS, CNM
• Keeona G Vance
• Terrill Lana Vance, LMT
• Vienna Rose Vance
• Vancouver Clinic Inc
• Vancouver Home Health Care Agency LLC
• Daniel Gregg Vandaam
• Edward Vandehey
• Tara R Vandehey, CADC II/QMHP

• Psychiatric/Mental Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.