| Second Chance Counseling Services, Llc | |
|
108 Stage Coach Lane Village Park Orangeburg SC 29118-2499 | |
| (803) 516-0200 | |
| (803) 516-8288 |
| Full Name | Second Chance Counseling Services, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 108 Stage Coach Lane, Orangeburg, South Carolina |
| Authorized Official Name and Position | James Furtick (DIRECTOR) |
| Authorized Official Contact | 8035160200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Second Chance Counseling Services, Llc 108 Stage Coach Lane Village Park Orangeburg SC 29118-2499 Ph: (803) 516-0200 | Second Chance Counseling Services, Llc 108 Stage Coach Lane Village Park Orangeburg SC 29118-2499 Ph: (803) 516-0200 |
| NPI Number | 1518023076 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 04/27/2023 |
| Certification Date | 04/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518023076 | NPI | - | NPPES |
| SW1049 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 302F00000X | Exclusive Provider Organization | 4068 (South Carolina) | Secondary |
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