Provider Demographics
NPI: | 1811433808 |
---|---|
Name: | NEW OPTION INC. |
Entity type: | Organization |
Organization Name: | NEW OPTION INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | MARIA |
Authorized Official - Middle Name: | GRACE |
Authorized Official - Last Name: | LAZZARO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MSW, LCSW |
Authorized Official - Phone: | 540-772-7267 |
Mailing Address - Street 1: | 2417 AIRPORT BLVD |
Mailing Address - Street 2: | |
Mailing Address - City: | NORTH MYRTLE BEACH |
Mailing Address - State: | SC |
Mailing Address - Zip Code: | 29582-4315 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 540-772-7267 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 10255 BEACH DR SW |
Practice Address - Street 2: | |
Practice Address - City: | CALABASH |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28467-2703 |
Practice Address - Country: | US |
Practice Address - Phone: | 540-772-7267 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-01-13 |
Last Update Date: | 2017-01-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | C002194 | 1041C0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Single Specialty |