Provider Demographics
NPI:1871252197
Name:SECOND CHANCE RANCH COUNSELING AND EQUINE THERAPY, LLC
Entity Type:Organization
Organization Name:SECOND CHANCE RANCH COUNSELING AND EQUINE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KARMA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MHSP
Authorized Official - Phone:901-410-1977
Mailing Address - Street 1:5199 HIDEAWAY LN
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38002-9791
Mailing Address - Country:US
Mailing Address - Phone:901-410-1977
Mailing Address - Fax:901-410-1977
Practice Address - Street 1:5199 HIDEAWAY LN
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38002-9791
Practice Address - Country:US
Practice Address - Phone:901-410-1977
Practice Address - Fax:901-410-1977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty