2ND CHANCE PROMISE PROGRAM — NPI 1992585111 (Licensed & Credentialed Counselor in NEW CASTLE, DE)

CMS-1500 Box 24J / 33a • NPI

1992585111

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

101Y00000X

Licensed & Credentialed Counselor

Box 32 Service Location & ZIP+4

19 LAMBSON LN STE B102, NEW CASTLE, DE, 19720-2118

✓ 9-Digit EDI 837 ZIP+4 (19720-2118)

Practice Phone & Referral Fax

(302) 337-5513

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1992585111 (2ND CHANCE PROMISE PROGRAM) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1992585111` (NPI-2 Organization / Facility)
Provider / Legal Name	2ND CHANCE PROMISE PROGRAM
Plain-English Specialty	Licensed & Credentialed Counselor NUCC Code: `101Y00000X` (Counselor)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	19 LAMBSON LN STE B102, NEW CASTLE, DE, 19720-2118
Practice Telephone / Fax	Tel: (302) 337-5513
Administrative Mailing Address	3113 N VAN BUREN ST, WILMINGTON, DE, 19802-2939
Enumeration & Last Sync	Enumerated: 2023-10-04 \| CMS Record Updated: 2023-10-04
Authorized Official	ANDRE HALEY (Owner/Provider)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

19 LAMBSON LN STE B102, NEW CASTLE, DE, 19720-2118

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Plain-English Taxonomy & CMS Crosswalk (101Y00000X)

What Does Taxonomy Code 101Y00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 101Y00000X translates to:
"Licensed & Credentialed Counselor"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Counselor for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (2ND CHANCE PROMISE PROGRAM)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`101Y00000X` — Counselor Plain English: Licensed & Credentialed Counselor	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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2ND CHANCE PROMISE PROGRAM (NPI #1992585111)