Provider Demographics
NPI:1619078144
Name:CHANCE, MARGIE (LPC, CADC-I)
Entity Type:Individual
Prefix:MS
First Name:MARGIE
Middle Name:
Last Name:CHANCE
Suffix:
Gender:F
Credentials:LPC, CADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 NW 9TH AVE
Mailing Address - Street 2:#106
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3255
Mailing Address - Country:US
Mailing Address - Phone:503-234-0985
Mailing Address - Fax:503-234-0995
Practice Address - Street 1:1255 NW 9TH AVE
Practice Address - Street 2:#106
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-3255
Practice Address - Country:US
Practice Address - Phone:503-234-0985
Practice Address - Fax:503-234-0995
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1465101Y00000X, 101YM0800X, 101YP2500X
OR01-03-07101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health