# CHRISTOPHER GLENN CHIVERTON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184187932
- **Authorized official:** CHRISTOPHER CHIVERTON (OWNER)
- **Authorized official phone:** (585) 613-2657

## Contact information

- **Practice address:** 386 FORE ST STE 304, PORTLAND, ME 04101-7406
- **Practice address phone:** (585) 613-2657
- **Mailing address:** 271 BRACKETT ST APT 1, PORTLAND, ME 04102-3219

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 04/09/2019
- **Last updated:** 04/09/2019