Second Chance Counseling PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SECOND CHANCE COUNSELING PLLC

Practice address

480 Route 17M FL 1
Middletown, NY 10940-4525

Phone

(845) 341-8008

Fax

(732) 244-1005

NPI assigned

Nov 29, 2021

Organization subpart

No

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

Authorized official

Name

Patricia R De Jesus, LCSWNPI 1083217954

Title

Provider

Phone

(845) 341-8008

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patricia Rena Dejesus

  • Clinical Social Worker
  • Middletown, NY
  • NPI 1083217954
  Medicare reassignment Care Compare group NPD Authorized official
• Jasmine Ortiz

  • Clinical Social Worker
  • Middletown, NY
  • NPI 1629638739
  Medicare reassignment Care Compare group NPD
• Jasmine Warren, LCSW

  • Clinical Social Worker
  • Middletown, NY
  • NPI 1821480955
  Medicare reassignment Care Compare group NPD
• Denine Cooper, LCSW

  • Clinical Social Worker
  • Middletown, NY
  • NPI 1831911197
  Medicare reassignment NPD
• Christina Edna Kowalski, LCSW

  • Clinical Social Worker
  • Middletown, NY
  • NPI 1326853516
  Medicare reassignment NPD

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1265190094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 DOGWOOD DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109401801",
            "telephone_number": "845-341-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 ROUTE 17M FL 1",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109404525",
            "telephone_number": "845-341-8008",
            "fax_number": "732-244-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND CHANCE COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-29",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "DE JESUS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "845-341-8008",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shimon Schwartz, M.D.
• Stephanie Schwartz, PHARMD
• Scotchtown Chiropractic PLLC
• Scotchtown Physical Therapy, P.C.
• Gabrielle Marie Sears, OTR/L
• Bonnie V Seecharran, M.D
• Ethan Thomas Seidl, FNP-BC
• Self Reflection Psychological Services, PLLC
• Robyn Sellet, LCSW
• Dhana Selvaraj, MD

• Clinical Social Worker in Middletown, NY
• Providers in Middletown, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.