NPIMap

Organization Active NPI

Campbell Second Chance Recovery Center

  • Mental Health Counselor
  • Rocky Mount, NC
National Provider Identifier
1295377653
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CAMPBELL SECOND CHANCE RECOVERY CENTER
Practice address
601 Tarboro St
Rocky Mount, NC 27801-5955
Phone
(910) 556-6130
NPI assigned
Oct 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Authorized official

Name
Mrs. Cynthia Ann CampbellNPI 1417599861
Title
Executive Director
Phone
(910) 556-6130

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary
Meals Provider 174200000X
Lodging Provider 177F00000X
Case Management Agency 251B00000X
Nursing Care Agency 251J00000X
Public Health or Welfare Agency 251K00000X
Voluntary or Charitable Agency 251V00000X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
Taxi 344600000X
Air Carrier 344800000X
Bus 347B00000X
Private Vehicle 347C00000X
Train 347D00000X

Addresses

Primary practice location

601 Tarboro St
Rocky Mount, NC 27801-5955

Mailing address

115 Appomattox Dr
Cameron, NC 28326-5536
Phone (910) 556-6130

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cscrc@outlook.com Direct
Direct Messaging Address cscrc@outlook.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1295377653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 APPOMATTOX DR",
            "city": "CAMERON",
            "state": "NC",
            "postal_code": "283265536",
            "telephone_number": "910-556-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 TARBORO ST",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278015955",
            "telephone_number": "910-556-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL SECOND CHANCE RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "910-556-6130",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "344600000X",
            "taxonomy_group": "",
            "desc": "Taxi",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "344800000X",
            "taxonomy_group": "",
            "desc": "Air Carrier",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347B00000X",
            "taxonomy_group": "",
            "desc": "Bus",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347D00000X",
            "taxonomy_group": "",
            "desc": "Train",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cscrc@outlook.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "115 Appomattox Dr",
            "city": "Cameron",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283265536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cscrc@outlook.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "115 Appomattox Dr",
            "city": "Cameron",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283265536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.