Organization
SECOND CHANCE COUNSELING, LLC
Active
Organization
SECOND CHANCE COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISHA KATHRYN HAWTHORNE LCSW, LADAC (CEO)
(505) 427-1621
Entity
Organization
Contact information
Practice address
719 W APACHE ST, FARMINGTON, NM 87401-5512
(505) 427-1621
Mailing address
719 W APACHE ST, FARMINGTON, NM 87401-5512
(505) 427-1621
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
5211247
NM
101YM0800X
Mental Health Counselor
5211247
NM
1041C0700X
Clinical Social Worker
Primary
5211247
NM
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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