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Organization
GOAL SUCCEEDERS
Active
Organization
GOAL SUCCEEDERS
Active
Other names
GOAL Succeeders
Organization subpart
No
Provider details
NPI number
Authorized official
CHAZ LAMAR CLYBURN PSS, CPC (CERTIFIED PEER COUNSELOR)
(757) 800-7806
Entity
Organization
Contact information
Practice address
4401 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23462-3106
(757) 800-7806
Mailing address
5217 SHADY GROVE LN, VIRGINIA BEACH, VA 23462-1787
(757) 800-7806
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
NULL
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
12/20/2019
Last updated
12/20/2019
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