Charlie'S Second Chance Counseling, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

CHARLIE'S SECOND CHANCE COUNSELING, LLC

Practice address

842 Oak St
Gainesville, GA 30501-3570

Phone

(470) 290-8684

NPI assigned

Oct 24, 2017

Organization subpart

No

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

Authorized official

Name

Myra MuckleNPI 1184135600

Title

Owner

Phone

(470) 290-8684

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Myra Terry Muckle

  • Professional Counselor
  • Gainesville, GA
  • NPI 1184135600
  NPD Authorized official

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1780195206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 OAK ST",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013570",
            "telephone_number": "470-290-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 OAK ST",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013570",
            "telephone_number": "470-290-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLIE'S SECOND CHANCE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-24",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "MUCKLE",
        "authorized_official_first_name": "MYRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-290-8684"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Jeffery Chappell, DO
• Antony Joseph Charles, MD
• Emmanuelle C Charles, PA-C
• Kevin Charles, M.D.
• Lawrence Charles, M.D.
• Gracie Charlton
• Rebecca Marie Charpentier, FNP
• Kelly Callahan Chase, APRN
• Colby T Chastain, M.D.
• Chattahoochee Child Psychology

• Professional Counselor in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.