Organization
SECOND CHANCE COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERESE NICOLE HAYES LCSW-C (PRESIDENT)
(301) 972-1373
Entity
Organization
Contact information
Practice address
19727 EXECUTIVE PARK CIR, GERMANTOWN, MD 20874-2642
(301) 972-1373
(301) 972-1584
Mailing address
PO BOX 882, CLARKSBURG, MD 20871-0882
(301) 972-1373
(301) 972-1584
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
905516
MD
101YP2500X
Professional Counselor
LC4015
MD
101YP2500X
Professional Counselor
LC4709
MD
101YP2500X
Professional Counselor
LC5475
MD
1041C0700X
Clinical Social Worker
12637
MD
133V00000X
Registered Dietitian
DX3109
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408867100
—
MD
Enumeration date
06/18/2013
Last updated
01/27/2026
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