SECOND CHANCE COUNSELING SERVICES, LLC (NPI# 1790040822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790040822 |
| Entity Type | Organization |
| Organization Name | SECOND CHANCE COUNSELING SERVICES, LLC |
| Practice Address |
114 E Hall St Thomson GA 30824-2726 |
| Mailing Address |
Po Box 10 Thomson GA 30824-0010 |
| Practice Telephone | 7065952548 |
| Practice Fax Number | 7065953070 |
| Mailing Telephone | 7065952548 |
| Mailing Fax Number | 7065953070 |
| Enumeration Date | 2012-07-04 |
| Last Update Date | 2014-05-27 |
| Authorized Official Name | MR. CHARLES EDWARD JONES (CEO) |
| Authorized Official Telephone | 7065952548 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | LPC006021 | GA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 0000606317B | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932594983 | Second Chance Counseling Services, LLC | Social Worker | 13241 Executive Park Ter, Germantown, MD 20874-2648 | 2015-04-06 |
| 1164817268 | Second Chance Counseling Services, LLC | Counselor | 13241 Executive Park Ter, Germantown, MD 20874-2648 | 2015-04-06 |
| 1053750521 | Second Chance Counseling Services, LLC | Dietitian, Registered | 13241 Executive Park Ter, Germantown, MD 20874-2648 | 2013-06-18 |
| 1518023076 | Second Chance Counseling Services, LLC | Exclusive Provider Organization | 198 Docket St Ste 201, Orangeburg, SC 29115-3114 | 2006-12-29 |
| Street Address |
114 E HALL ST |
| City | THOMSON |
| State | GA |
| Zip Code | 30824-2726 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790955383 | Gloria Gene Moses | Counselor | 114 E Hall St, Thomson, GA 30824-2726 | 2008-03-10 |
| 1629558390 | Lisa Modlin | Counselor | 114 E Hall St, Thomson, GA 30824-2726 | 2018-08-21 |
| 1801310750 | Rosalind Felecia Scott | Counselor | 114 E Hall St, Thomson, GA 30824-2726 | 2017-08-02 |
| 1497162374 | Wanda Sanders | Counselor | 114 E Hall St, Thomson, GA 30824-2726 | 2014-07-12 |
| 1063737955 | Nisha Gandhi Wilson | Counselor | 114 E Hall St, Thomson, GA 30824-2726 | 2010-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306591 | Connie Deverell Tam | Pharmacist | Walmart Pharmacy #1658, 2205 Harrison Rd, Thomson, GA 30824 | 2020-11-02 |
| 1750878039 | Amber Nichole Wood | Student in an Organized Health Care Education/Training Program | 355 Bard Avenue Department of Psychiatry, 1st Floor, Staten Island, NY 30824 | 2018-04-22 |
| 1861854176 | Family Care Group of Thomson,inc | Family Medicine | 2508 University Dr, Thomson, GA 30824 | 2016-03-25 |
| 1174900674 | Carolyn Louise Samuels | Behavioral Analyst | 1139 Washington Rd, Thomson, GA 30824 | 2015-05-04 |
| 1013343953 | David Carroll Hughes | Dentist | 540 West Hill St., Thomson, GA 30824 | 2013-09-24 |
| 1295067270 | Wesley Alan Mccarthy | Counselor | 114 East Hall Street, Thompson, GA 30824 | 2010-02-02 |
| 1417280439 | Charles Edward Jones | Counselor | 114 East Hall St, Thomson, GA 30824 | 2009-09-09 |
| 1700055779 | Drs Jopling and Brunson | Dentist | 115 Gordon Street, Thomson, GA 30824 | 2008-02-25 |
| 1871630483 | Robert F. Polglase | Emergency Medicine | 521 Hill St, S.w., Thomson, GA 30824 | 2007-01-31 |
| 1861553141 | The Homeplace Adult Daycare, Inc. | Custodial Care Facility | 1324 Wrightsboro Road, Thomson, GA 30824 | 2006-12-12 |
| Find all providers in zip 30824 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871834341 | Brandon A Coussens Lmft LLC | Community/Behavioral Health | 654 Main St, Ste 6, Thomson, GA 30824-7403 | 2013-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376160 | Love, Breanna Olivia Zion Enterprise,llc(lboz): | Community/Behavioral Health | 9802 N Ivy Park Dr, Fortson, GA 31808-7130 | 2020-11-02 |
| 1578170882 | Helping Hearts Behavioral Health Services, LLC | Community/Behavioral Health | 504 Hamlet Dr, Hampton, GA 30228-4829 | 2020-09-30 |
| 1982219523 | Future Seekers, Inc. | Community/Behavioral Health | 3475 N. Desert Drive, Building 1, Suite 2100, East Point, GA 30344-3034 | 2020-09-10 |
| 1396359840 | Just Like Family Caregivers | Community/Behavioral Health | 2628 Lovejoy Crossing St, Hampton, GA 30228-5995 | 2020-09-02 |
| 1285247270 | Hudu Yoga & Therapy | Community/Behavioral Health | 3900 Springleaf Ct, Stone Mountain, GA 30083-4692 | 2020-08-28 |
| 1952914632 | Brighter Dayz, Incorporated | Community/Behavioral Health | 1016 Howell Mill Rd Nw Apt 4408, Atlanta, GA 30318-5592 | 2020-08-24 |
| 1699387688 | Rise Rehabilitation Services, LLC | Community/Behavioral Health | 738 Highland Park Trl, Atlanta, GA 30350-6706 | 2020-08-20 |
| 1104438373 | Pivotal Counseling LLC | Community/Behavioral Health | 75 N Broad St, Winder, GA 30680-1907 | 2020-08-19 |
| 1295347888 | Freemans Early Intervention Services | Community/Behavioral Health | 13 Peach St, Butler, GA 31006 | 2020-08-17 |
| 1861017634 | Trinity Care Counseling | Community/Behavioral Health | 3475 Northwinds Parkway, 200, Alpharetta, GA 30009 | 2020-06-08 |
| Find all providers with the same taxonomy | ||||
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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.