Provider Demographics
NPI:1821759028
Name:GOSS, LAKITA LAJOY
Entity Type:Individual
Prefix:
First Name:LAKITA
Middle Name:LAJOY
Last Name:GOSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 STARR AVE STE A
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-4032
Mailing Address - Country:US
Mailing Address - Phone:662-268-8059
Mailing Address - Fax:
Practice Address - Street 1:100 STARR AVE STE A
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-4032
Practice Address - Country:US
Practice Address - Phone:662-268-8059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor