Provider Demographics
NPI:1225687601
Name:GOODING, PAUL YURI (LPC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:YURI
Last Name:GOODING
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:YURI
Other - Middle Name:
Other - Last Name:GOODING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:216 E RANDALL AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-3538
Mailing Address - Country:US
Mailing Address - Phone:412-999-1598
Mailing Address - Fax:
Practice Address - Street 1:4410 CLAIBORNE SQ E STE 334
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2074
Practice Address - Country:US
Practice Address - Phone:757-977-0889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008604101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional