SECOND START, LLC (NPI# 1114449162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114449162 |
Entity Type | Organization |
Organization Name | SECOND START, LLC |
Practice Address |
1432 Baychester Ave Apt A4 Norfolk VA 23503-2320 |
Practice Telephone | (919) 423-9062 |
Mailing Telephone | 9194239062 |
Enumeration Date | 2017-07-12 |
Last Update Date | 2017-07-12 |
Authorized Official Name | MRS. JOY CHESTNUT (QUALITY MANAGEMENT DIRECTOR) |
Authorized Official Telephone | 7049951656 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
N | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers | ||
N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
Street Address |
1432 BAYCHESTER AVE APT A4 |
City | NORFOLK |
State | VA |
Zip Code | 23503-2320 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598371924 | Senita Bright | Home Health Aide | 8831 Mariners Cove Apt A, Norfolk, VA 23503 | 2020-09-21 |
1982247169 | Loretta Bernadette Gardner | Technician | 589 West Oceanview #2, Norfolk, VA 23503 | 2019-10-21 |
1891172367 | Diamond Life Services Charity Incorporated | Community/Behavioral Health | 935 Virgilina Avenue, Norfolk, VA 23503 | 2015-05-04 |
1114321577 | Tamira Mckinley | Developmental Therapist | 225 A View Ave, Unit 107, Norfolk, VA 23503 | 2014-10-14 |
1205929130 | Hope In Home Care LLC | Respite Care | 6325 North Center Drive, Ste 206, Norfolk, VA 23503 | 2006-10-02 |
1962555052 | Jason Robert Bernhard | Preventive Medicine | Uss Dwight D. Eisenhower Cvn 69, Norfolk, VA 23503 | 2007-01-19 |
1124186903 | Hope In Home Care LLC | Technician | 6325 North Center Drive, Ste 206, Norfolk, VA 23503 | 2006-12-05 |
1639559537 | Don-thomas Tindle | Physician Assistant | 1501 Chela Ave, Norfolk, VA 23503-1006 | 2015-06-05 |
1063590313 | Laura M Stacey | Behavioral Analyst | 1418 W Ocean View Ave, Norfolk, VA 23503-1015 | 2006-11-02 |
1376781849 | Mattie L. Brown | Counselor | 1382 W Ocean View Ave # B, Norfolk, VA 23503-1108 | 2009-01-21 |
Find all providers in zip 23503 |
Taxonomy Code | 101Y00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114567666 | Terri Widen | Counselor | 110 Maycox Ave Ste 3, Norfolk, VA 23505-3433 | 2020-01-13 |
1093357048 | Krystal Vaughn | Counselor | 870 N Military Hwy Ste 208, Norfolk, VA 23502-3638 | 2019-10-10 |
1861950818 | Mike Moreno | Counselor | 2420 W Omaha Ave, Norfolk, NE 68701-1526 | 2019-03-08 |
1316404544 | Bold Ruler, LLC | Counselor | 957 W 21st St Ste L, Norfolk, VA 23517-1536 | 2019-02-24 |
1801363189 | Positive Wellness and Recovery LLC | Counselor | 5900 E Virginia Beach Blvd Ste 302, Norfolk, VA 23502-2488 | 2018-10-25 |
1922546746 | Family Wellness and Recovery Center, LLC | Counselor | 5121 E. Virginia Beach Blvd, Suite C-2, Norfolk, VA 23502-4041 | 2017-02-01 |
1457750051 | Kevin Weaver | Counselor | 846 W 35th St, Norfolk, VA 23508-3011 | 2014-08-19 |
1295144343 | Bethany Arcand | Counselor | 934 Armfield Cir Apt 204, Norfolk, VA 23505-3235 | 2014-08-02 |
1598104978 | Jennifer Lee Levine | Counselor | 206 Dedham St, Norfolk, MA 02056-1667 | 2013-06-19 |
1508140856 | Susan Cianfaglione | Counselor | 1526 Versailles Ave, No. 1, Norfolk, VA 23509-1146 | 2011-10-05 |
Find all providers in NORFOLK |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.