Individual
JERRY GOFORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
732 DAVIS AVE, WHITEVILLE, NC 28472-6002
(910) 640-1038
Mailing address
732 DAVIS AVE, 732 DAVIS AVENUE, WHITEVILLE, NC 28472-6002
(910) 640-1465
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7408
NC
Other
Enumeration date
06/30/2009
Last updated
08/25/2011
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