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Organization
SECOND CHANCE COUNSELING SERVICES, LLC
Active
Organization
SECOND CHANCE COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES FURTICK JR. PH.D (DIRECTOR)
(803) 516-0200
Entity
Organization
Contact information
Practice address
108 STAGE COACH LANE, VILLAGE PARK, ORANGEBURG, SC 29118-2499
(803) 516-0200
(803) 516-8288
Mailing address
108 STAGE COACH LANE, VILLAGE PARK, ORANGEBURG, SC 29118-2499
(803) 516-0200
(803) 516-8288
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
302F00000X
Exclusive Provider Organization
4068
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SW1049
—
SC
Enumeration date
12/29/2006
Last updated
04/27/2023
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