Provider Demographics
NPI:1144745332
Name:2ND CHANCE COUNSELING SERVICE LLC
Entity Type:Organization
Organization Name:2ND CHANCE COUNSELING SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHIMPF-PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:CAC
Authorized Official - Phone:570-691-6347
Mailing Address - Street 1:1700 SULLIVAN TRL # 126
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-8333
Mailing Address - Country:US
Mailing Address - Phone:570-212-9222
Mailing Address - Fax:
Practice Address - Street 1:204 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77399-2004
Practice Address - Country:US
Practice Address - Phone:570-691-6347
Practice Address - Fax:570-691-6347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-08
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty