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
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MHL-032-506
NC
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8302362B
—
NC
05
—
8302362G
—
NC
05
—
8302362Q
—
NC
05
—
8302703B
—
NC
05
—
8302703G
—
NC
05
—
8700391
—
NC
Enumeration date
02/12/2010
Last updated
08/29/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us