Second Wind Recovery and Support Services PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

490 Issued in OK

Legal business name

SECOND WIND RECOVERY AND SUPPORT SERVICES PLLC

Practice address

3700 N Classen Blvd
Suite C-55
Oklahoma City, OK 73118-2872

Phone

(405) 605-0881

Fax

(405) 605-0879

NPI assigned

Apr 24, 2014

Last updated

Apr 24, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Jacquelyn D. Jordan, MA, LADC

Title

Ceo/Owner

Phone

(405) 605-0881

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jackie D Jordan, MA, LADC

  • Addiction (Substance Use Disorder) Psychologist
  • Oklahoma City, OK
  • NPI 1114263001
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1215357660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 N CLASSEN BLVD",
            "address_2": "SUITE C-55",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731182872",
            "telephone_number": "405-605-0881",
            "fax_number": "405-605-0879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 N CLASSEN BLVD",
            "address_2": "SUITE C-55",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731182872",
            "telephone_number": "405-605-0881",
            "fax_number": "405-605-0879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND WIND RECOVERY AND SUPPORT SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "405-605-0881",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, LADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200530290A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1114263001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Sebert, MS,
• Joseph Paul Sebourn, DDS
• Shelby Nicole Sebring
• Jamie Lynae Seckel, PTA
• Second Act Counseling, Coaching and Consulting, LLC
• Megan Marie Secrest, MSW, LCSW
• Secret of the Heart Transitional Living
• Lauren Michelle Secrist, DNP, APRN, PMHNP-BC
• Mary Anne Secrist, MS, RN, CNS
• Madeline Jessop Sedgwick

• Community/Behavioral Health Agency in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Community/Behavioral Health Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.