Doctor Name: | MR. VERLIN BERNARD GOODING |
NPI Number: | 1437491578 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC |
License Number: | LC1882 |
Business Practice Address: | 1113 Ivy Club Ln Unit 742 Landover, MD - 207854521 |
Business Phone Number: | 3013792619 |
Business Fax Number: | |
Mailing Address: | Po Box 6095, LARGO |
State: | MD |
Postal Code: | 207926095 |
Phone Number: | 3013792619 |
Fax Number: | |
NPI Enumeration Date: | 03/26/2013 |
NPI Last Update Date: | 03/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LC1882 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |