SECOND CHANCES YOUTH SERVICES, LLC (NPI# 1568860336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568860336 |
| Entity Type | Organization |
| Organization Name | SECOND CHANCES YOUTH SERVICES, LLC |
| Other Organization Name | SECOND CHANCES COMPREHENSIVE SERVICES |
| Practice Address |
2638 Two Notch Rd Suite 106 Columbia SC 29204-1454 |
| Practice Telephone | 8035696263 |
| Mailing Telephone | 8035696263 |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2014-12-10 |
| Authorized Official Name | MRS. TANIKKA LASHELLE MASON (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 8047213306 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 1389-01-001 | VA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1245530500 | 05 | |
| VA | 1760755383 | 05 | |
| VA | 18314320660 | 05 |
| Other Name | Type Code |
|---|---|
| Second Chances Comprehensive Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831420660 | Second Chances Youth Services, LLC | In Home Supportive Care | 2002 Wakefield Ave, Petersburg, VA 23805-2112 | 2010-01-18 |
| Street Address |
2638 TWO NOTCH RD SUITE 106 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29204-1454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871546226 | Sara G Fuller | Nurse Practitioner | 2638 Two Notch Rd, Suite 110, Columbia, SC 29204-1454 | 2006-05-18 |
| 1770943235 | Victoria Hollingsworth Davis | Registered Nurse | 2638 Two Notch Rd, Suite 110, Columbia, SC 29204-1454 | 2016-02-26 |
| 1316323348 | Jim Manning | Social Worker | 2638 Two Notch Rd, Suite 108, Columbia, SC 29204-1454 | 2015-07-31 |
| 1053730572 | Palmetto Family Service Center of Sc | Community/Behavioral Health | 2638 Two Notch Rd, Suite 108, Columbia, SC 29204-1454 | 2014-04-11 |
| 1689910572 | South Carolina Department of Social Services | Case Management | 2638 Two Notch Rd, Suite 200, Columbia, SC 29204-1454 | 2012-12-20 |
| 1508126087 | Delores Michelle Madison | Counselor | 2638 Two Notch Rd, Suite 106, Columbia, SC 29204-1454 | 2012-05-18 |
| 1710258678 | Shannon Elizabeth Phillips | Counselor | 2638 Two Notch Rd, Suite 106, Columbia, SC 29204-1454 | 2012-01-24 |
| 1740550318 | Lauren Elaine Trollinger | Counselor | 2638 Two Notch Rd, Suite 106, Columbia, SC 29204-1454 | 2012-01-12 |
| 1013295807 | Alison York Sanderson | Counselor | 2638 Two Notch Rd, Columbia, SC 29204-1454 | 2011-07-27 |
| 1316250632 | Sheryl Mcalhaney Brown | Counselor | 2638 Two Notch Rd, Suite 106, Columbia, SC 29204-1454 | 2010-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992215149 | Ricardo Colon II | Registered Nurse | 3000 Hampton Street, Columbia, SC 29204 | 2017-10-02 |
| 1780113522 | Carla Star Noe | Registered Nurse | Sc Department of Health and Environmental Control, 2100 Bull Street, Collumbia, SC 29204 | 2017-06-06 |
| 1124568514 | Kristy L Thompson | Nurse Practitioner | 1655 Bernardin Ave Ste 240, Columbia, SC 29204 | 2017-03-03 |
| 1982052031 | Harold Eugene Cook Iv | Podiatrist | 1730 St Julian Place, Columbia, SC 29204 | 2016-05-31 |
| 1851748974 | Shaquita Banks | Counselor | 1810 Allen Benedict Ct, A1, Columbia, SC 29204 | 2016-05-18 |
| 1265804835 | Premier Care, LLC | Case Management | 2712 Middleburg Drive, Suite 206, Columbia, SC 29204 | 2015-10-22 |
| 1023492287 | Shamiquia N. Mcpherson | Counselor | 1627 Auburn St., Columbia, SC 29204 | 2015-07-16 |
| 1285028449 | The Columbia Free Medical Clinic, Inc. | Clinic/Center | 1875 Harden Street, Columbia, SC 29204 | 2015-03-26 |
| 1629473459 | Leslie Wilson | Counselor | 2323 Lady Street, Columbia, SC 29204 | 2014-10-22 |
| 1053728683 | Candyce Sutton | Social Worker | 1135 Carter Street, Columbia, SC 29204 | 2014-07-15 |
| Find all providers in zip 29204 | ||||
| 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 |
|---|---|---|---|---|
| 1902403116 | Pieces 2 Peace Wellness Center, LLC | Community/Behavioral Health | 1105 Belleview St Ste 103, Columbia, SC 29201-1839 | 2020-10-01 |
| 1710507090 | Adahsa Counseling LLC | Community/Behavioral Health | 200 Eascott Pl, Columbia, SC 29229-5502 | 2020-04-16 |
| 1740809862 | Brsi Lp | Community/Behavioral Health | 8901 Farrow Rd, Columbia, SC 29203-8930 | 2020-04-09 |
| 1790324986 | Bransand | Community/Behavioral Health | 402 Nautique Cir, Columbia, SC 29229-7334 | 2020-01-05 |
| 1518513795 | Carolina Family Wellness Clinic, LLC | Community/Behavioral Health | 9153 Two Notch Rd Ste 6, Columbia, SC 29223-5852 | 2019-08-14 |
| 1073174033 | David Hill Consultants, LLC | Community/Behavioral Health | 1818 Pulaski St, Columbia, SC 29201-2381 | 2019-06-21 |
| 1760943005 | Goodecounsel, LLC. | Community/Behavioral Health | 235 Village Walk, Columbia, SC 29209-2166 | 2019-03-28 |
| 1932672961 | Sunshine Counseling Lc | Community/Behavioral Health | 302 Hampton Forest Dr, Columbia, SC 29209-2572 | 2019-01-02 |
| 1285125757 | Carolina Counseling Consultants | Community/Behavioral Health | 7356 Garners Ferry Rd Ste 112, Columbia, SC 29209-2146 | 2018-05-21 |
| 1114414125 | Teal Fire Counseling & Consulting, LLC | Community/Behavioral Health | 10632 Little Patuxent Pkwy Ste 343, Columbia, MD 21044-6239 | 2018-04-16 |
| Find all providers in COLUMBIA | ||||
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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.