Second Chance Addiction Care

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SECOND CHANCE ADDICTION CARE

Practice address

401 E Jefferson St Ste 203
Rockville, MD 20850-2617

Phone

(301) 983-5130

Fax

(855) 270-6701

NPI assigned

Jun 15, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Cheryl Ann Moore, LCSW-C

Title

Clinical Director

Phone

(240) 723-5018

Specialties & licenses 2

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1124703418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 FALLS RD STE 7",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208543942",
            "telephone_number": "301-983-5130",
            "fax_number": "855-270-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E JEFFERSON ST STE 203",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208502617",
            "telephone_number": "301-983-5130",
            "fax_number": "855-270-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND CHANCE ADDICTION CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "240-723-5018",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500320200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ava Seay
• Sierra Seay
• Renzon Sebastian
• Thomas Michael Sebert, OTR/L
• Nina Seborowski, M.D.
• Second Chance Addiction Care
• Second Chance Addiction Care LLC
• Second Chance Addiction Care LLC
• Second Chance Addiction Care LLC
• Ivette Secundino-Isidro

• Substance Abuse Rehabilitation Facility in Rockville, MD
• Providers in Rockville, MD by specialty
• Substance Abuse Rehabilitation Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.