Organization
SECOND START, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOY CHESTNUT (QUALITY MANAGEMENT DIRECTOR)
(704) 995-1656
Entity
Organization
Contact information
Practice address
1432 BAYCHESTER AVE APT A4, NORFOLK, VA 23503-2320
(919) 423-9062
Mailing address
1432 BAYCHESTER AVE APT A4, NORFOLK, VA 23503-2320
(919) 423-9062
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
07/12/2017
Last updated
07/21/2022
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