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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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
YTF885133438
VA
Enumeration date
12/20/2019
Last updated
12/20/2019
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