Healthcare Provider Details

I. General information

NPI: 1649198383
Provider Name (Legal Business Name): NEW BEGINNINGS EMERGENCY SHELTER, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 REHOBETH CHURCH RD
CLARKTON NC
28433-8014
US

IV. Provider business mailing address

142 REHOBETH CHURCH RD
CLARKTON NC
28433-8014
US

V. Phone/Fax

Practice location:
  • Phone: 877-716-8372
  • Fax: 731-254-1459
Mailing address:
  • Phone: 877-716-8372
  • Fax: 731-254-1459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LAVENDA TERESA ROGERS
Title or Position: CEO
Credential: MSW,MA,LCSW,LCAS
Phone: 877-716-8372