SECOND CHANCE, LLC (NPI# 1194325191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194325191 |
| Entity Type | Organization |
| Organization Name | SECOND CHANCE, LLC |
| Practice Address |
315 Hospital Dr Ste 105 Martinsville VA 24112-1927 |
| Mailing Address |
Po Box 3699 Martinsville VA 24115-3699 |
| Practice Telephone | 2762019506 |
| Mailing Telephone | 7573209331 |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | LISA MCINTOSH (LPC) |
| Authorized Official Telephone | 7573209331 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | SECOND CHANCE, LLC | 146 Fairfield Dr, Holbrook, Ny 11741 |
| Connecticut Business Registrations | SECOND CHANCE, LLC | 73 North Pearl Street, Meriden, CT 06450 |
| Street Address |
315 HOSPITAL DR STE 105 |
| City | MARTINSVILLE |
| State | VA |
| Zip Code | 24112-1927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205327038 | Martinsville Transit, LLC | Taxi | 807 Barrows Mill Rd Apt E, Martinsville, VA 24112 | 2018-05-29 |
| 1699279422 | Terry Michelle Hamdy | Nurse Practitioner | 110 Commonwealth Blvd, Martinsville, VA 24112 | 2018-03-19 |
| 1780184523 | Susan Fullerton | Speech-Language Pathologist | 288 Lancer Lane, Martinsville, VA 24112 | 2018-02-19 |
| 1164920062 | Aesthetic & Family Dental of Martinsville PC | Dentist | 5 Dudley Street, Martinsville, VA 24112 | 2018-01-25 |
| 1124537410 | Hamdy Medical Center, PC | Clinic/Center | 110 W Commonwealth Blvd, Martinsville, VA 24112 | 2017-09-29 |
| 1588180483 | Olton Swanson | Driver | 1440 Rivermount Heights, Martinsville, VA 24112 | 2017-08-22 |
| 1639610686 | Stephanie Hairston | Non-emergency Medical Transport (VAN) | 912 Brookdale St, Ste 1, Martinsville, VA 24112 | 2017-03-10 |
| 1194182790 | Jns Home Healthcare Services | In Home Supportive Care | 708 Berkshire Place, Martinsville, VA 24112 | 2016-01-27 |
| 1033506654 | Caring Hearts Counseling LLC | Community/Behavioral Health | 624 East Church, Suite B, Martinsville, VA 24112 | 2015-04-21 |
| 1073915559 | Shirley Jackson | Occupational Therapy Assistant | 170 Village Court, Martinsville, VA 24112 | 2014-09-16 |
| Find all providers in zip 24112 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679081103 | Sherery Roshelle Brown | Clinic/Center | 916 Brookdale St Ste 2, Martinsville, VA 24112-3105 | 2018-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454515 | Always Blossom, LLC | Clinic/Center | 611 W Graham Rd, Richmond, VA 23222-4207 | 2020-10-12 |
| 1225645377 | Crescent Moon Counseling LLC | Clinic/Center | 8016 Burrundie Dr, Richmond, VA 23225-1972 | 2020-09-23 |
| 1811512007 | Schwarz Counseling and Coaching | Clinic/Center | 8109 Mechanicsville Turnpike, Suite 1c, Mechanicsville, VA 23111 | 2020-06-12 |
| 1174146708 | Nova Telemental Health | Clinic/Center | 14012 Willet Way, Gainesville, VA 20155-5915 | 2020-05-18 |
| 1659993731 | Sandstone Care Virginia, LLC | Clinic/Center | 11415 Isaac Newton Sq S, Reston, VA 20190-5005 | 2020-05-12 |
| 1306467147 | Shenandoah Creative Counseling for Children and Adolescents | Clinic/Center | 510 W Broad St Ste H, Waynesboro, VA 22980-4548 | 2020-05-04 |
| 1801449855 | Amazing Counseling LLC | Clinic/Center | 2428 Windy Pines Bnd, Virginia Beach, VA 23456-3954 | 2019-07-18 |
| 1366007460 | Absolute Mental Health Clinic LLC | Clinic/Center | 1303 Florida Ave, Woodbridge, VA 22191-3620 | 2019-05-03 |
| 1912468190 | Village Therapeutic Mentoring Services LLC | Clinic/Center | 1 W Cary St, Richmond, VA 23220-5609 | 2019-03-28 |
| 1801375118 | Clementine Twin Lakes, LLC | Clinic/Center | 13215 Twin Lakes Dr, Clifton, VA 20124-1215 | 2018-08-08 |
| Find all providers with the same taxonomy | ||||
| City | MARTINSVILLE |
| Zip Code | 24112 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.