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Organization
NEW OUTLOOK..SECOND CHANCE, INC.
Active
Organization
NEW OUTLOOK..SECOND CHANCE, INC.
Active
Parent organization
NEW OUTLOOK..SECOND CHANCE, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEW OUTLOOK..SECOND CHANCE, INC.
Authorized official
MS. BETHENA M JACKSON BA, CSAC (CHIEF EXECUTIVE OFFICER)
(919) 682-4771
Entity
Organization
Contact information
Practice address
2604 CARVER ST, SUITE C, DURHAM, NC 27705-2796
(919) 682-4771
(919) 683-2641
Mailing address
PO BOX 802, DURHAM, NC 27702-0802
(919) 682-4771
(919) 683-2641
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MHL-032-506
NC
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
Other
Enumeration date
02/12/2010
Last updated
08/29/2012
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