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
Update your record
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