Organization
SOUTHEAST SECOND CHANCE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE CRUWYS LCSW (OWNER)
(912) 265-2055
Entity
Organization
Contact information
Practice address
600 G ST STE 6, BRUNSWICK, GA 31520-6727
(912) 265-2055
(912) 265-2509
Mailing address
PO BOX 2727, BRUNSWICK, GA 31521-2727
(912) 265-2055
(912) 265-2509
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003287
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
851663137A
—
GA
Enumeration date
03/19/2007
Last updated
02/06/2023
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