NPIMap

Organization Active NPI

2ND Chance Rediscovery

  • Community/Behavioral Health Agency
  • Bishop, CA
National Provider Identifier
1629704184
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
2ND CHANCE REDISCOVERY
Practice address
1851 Shoshone Dr
Bishop, CA 93514-8115
Phone
(171) 447-8204
NPI assigned
Jul 27, 2022
Last updated
Jul 27, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SINFULXVANITY ART AND DESIGN LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Authorized official

Name
Kaitlin Elizabeth CromNPI 1740916204
Title
Executive Director
Phone
(714) 478-2044

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X
Graphics Designer 1744G0900X
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1851 Shoshone Dr
Bishop, CA 93514-8115

Mailing address

1851 Shoshone Dr
Bishop, CA 93514-8115
Phone (171) 447-8204

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kaitlin.crom@sinfulxvanity.org Direct

National Provider Directory

National Provider Directory
Part of
2ND Chance Rediscovery

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658880000000",
    "number": "1629704184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 SHOSHONE DR",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935148115",
            "telephone_number": "171-447-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 SHOSHONE DR",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935148115",
            "telephone_number": "171-447-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2ND CHANCE REDISCOVERY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SINFULXVANITY ART AND DESIGN LLC",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "CROM",
        "authorized_official_first_name": "KAITLIN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "714-478-2044"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1744G0900X",
            "taxonomy_group": "",
            "desc": "Specialist, Graphics Designer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kaitlin.crom@sinfulxvanity.org",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1851 Shoshone Dr",
            "city": "Bishop",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935148115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bishop, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.