Provider Demographics
NPI:1275629768
Name:GOFF, THERESA FRANCISCO (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:FRANCISCO
Last Name:GOFF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 KINGS LYNN RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-3813
Mailing Address - Country:US
Mailing Address - Phone:804-399-2297
Mailing Address - Fax:866-745-6213
Practice Address - Street 1:2401 KINGS LYNN RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-3813
Practice Address - Country:US
Practice Address - Phone:804-339-2297
Practice Address - Fax:866-745-6213
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040044821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical