Provider Demographics
NPI:1861739476
Name:CHANCE, CAROLINE (LMFT)
Entity type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:
Last Name:CHANCE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 NW 6TH ST
Mailing Address - Street 2:SUITE C-2
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-2226
Mailing Address - Country:US
Mailing Address - Phone:352-376-5543
Mailing Address - Fax:
Practice Address - Street 1:1031 NW 6TH ST
Practice Address - Street 2:SUITE C-2
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-2226
Practice Address - Country:US
Practice Address - Phone:352-376-5543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT1562106H00000X
FLMT2795106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist