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NEW OUTLOOK..SECOND CHANCE INC. NPI 1518299791


NPI Information

NPI: 1518299791
Provider Name: NEW OUTLOOK..SECOND CHANCE, INC.
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
2604 CARVER ST
SUITE C
DURHAM, NC
ZIP 27705
Phone: (919) 682-4771
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NEW OUTLOOK..SECOND CHANCE, INC. is an addiction (substance use disorder) counselor in Durham, NC. NEW OUTLOOK..SECOND CHANCE, INC. NPI is 1518299791. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2604 CARVER ST
SUITE C
DURHAM, NC
ZIP 27705-796
Phone: (919) 682-4771
Fax: (919) 683-2641

The provider's authorized official is Bethena M Jackson .
The authorized official title is Chief Executive Officer and has the following contact phone number (919) 682-4771.

The enumeration date for this NPI number is 2/12/2010 and was last updated on 8/29/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorNo
2103T00000XPsychologistNo
3104100000XSocial WorkerNo
4101YA0400XCounselorAddiction (Substance Use Disorder)MHL-032-506NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18302362GMEDICAIDNORTH CAROLINA
28302703BMEDICAIDNORTH CAROLINA
38302362BMEDICAIDNORTH CAROLINA
48302703GMEDICAIDNORTH CAROLINA
58302362QMEDICAIDNORTH CAROLINA
68700391MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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