Individual
JEREL LEMAR GOFORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1728 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23454-4533
(844) 909-2375
Mailing address
5605 LARRY AVE, VIRGINIA BEACH, VA 23462-1713
(773) 733-9898
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/18/2026
Last updated
03/18/2026
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