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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
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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