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SECOND CHANCE COUNSELING SERVICES LLC NPI 1053750521


NPI Information

NPI: 1053750521
Provider Name: SECOND CHANCE COUNSELING SERVICES, LLC
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
13241 EXECUTIVE PARK TER
GERMANTOWN, MD
ZIP 20874
Phone: (301) 972-1373
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SECOND CHANCE COUNSELING SERVICES, LLC is an addiction (substance use disorder) counselor in Germantown, MD. SECOND CHANCE COUNSELING SERVICES, LLC NPI is 1053750521. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

13241 EXECUTIVE PARK TER
GERMANTOWN, MD
ZIP 20874-648
Phone: (301) 972-1373
Fax: (301) 972-1584

The provider's authorized official is Terese Hayes .
The authorized official title is Owner and has the following contact phone number (301) 972-1373.

The enumeration date for this NPI number is 6/18/2013 and was last updated on 3/27/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1133V00000XDietitian, RegisteredDX3109MARYLANDNo
2101YP2500XCounselorProfessionalLC5475MARYLANDNo
3101YP2500XCounselorProfessionalLC4709MARYLANDNo
4101YP2500XCounselorProfessionalLC4015MARYLANDNo
51041C0700XSocial WorkerClinical12637MARYLANDNo
6101YA0400XCounselorAddiction (Substance Use Disorder)905516MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1492249MEDICARE PIN
2408867100MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.