| Second Chance Behavioral Health | |
|
1425 S Glenburnie Rd Ste 3 New Bern NC 28562-2610 | |
| (252) 514-9888 | |
| (252) 514-2881 |
| Full Name | Second Chance Behavioral Health |
|---|---|
| Speciality | Counselor |
| Location | 1425 S Glenburnie Rd Ste 3, New Bern, North Carolina |
| Authorized Official Name and Position | Tysha D Ushry (OWNER/THERAPIST) |
| Authorized Official Contact | 9103332789 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Second Chance Behavioral Health 1425 S Glenburnie Rd Ste 3 New Bern NC 28562-2610 Ph: (252) 514-9888 | Second Chance Behavioral Health 1425 S Glenburnie Rd Ste 3 New Bern NC 28562-2610 Ph: (252) 514-9888 |
| NPI Number | 1205341112 |
|---|---|
| Provider Enumeration Date | 12/14/2017 |
| Last Update Date | 02/27/2019 |
| Medicare PECOS PAC ID | 2961836408 |
|---|---|
| Medicare Enrollment ID | O20191217000301 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205341112 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 11560 (North Carolina) | Primary |
| Provider Name | Nora R Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740381102 PECOS PAC ID: 6507892478 Enrollment ID: I20050712000721 |
| Provider Name | Kim Renae English |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659476240 PECOS PAC ID: 7113106311 Enrollment ID: I20110120000156 |
| Provider Name | Leistey E Tindall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326588492 PECOS PAC ID: 9032489075 Enrollment ID: I20170724002628 |
| Provider Name | Maykin Kimberly Boyd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376021949 PECOS PAC ID: 7911318456 Enrollment ID: I20201204000893 |
| Provider Name | Delana Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710643309 PECOS PAC ID: 0648667402 Enrollment ID: I20220425002727 |
| Provider Name | Shamika J Ushry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326765215 PECOS PAC ID: 7618344466 Enrollment ID: I20221108000119 |
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