Provider Demographics
NPI:1194279299
Name:SUMMERS, CHANCE PARKER (LPC)
Entity type:Individual
Prefix:
First Name:CHANCE
Middle Name:PARKER
Last Name:SUMMERS
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3155 S MOODY AVE APT 719
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4735
Mailing Address - Country:US
Mailing Address - Phone:503-956-6255
Mailing Address - Fax:
Practice Address - Street 1:2143 NE BROADWAY ST STE 9
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1512
Practice Address - Country:US
Practice Address - Phone:503-956-6255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC8066101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health