Provider Demographics
NPI:1942859848
Name:GOINS, LAKITA ANN
Entity Type:Individual
Prefix:MS
First Name:LAKITA
Middle Name:ANN
Last Name:GOINS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LAKITA
Other - Middle Name:ANN
Other - Last Name:BOOKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 WHISPERING BREEZE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-6285
Mailing Address - Country:US
Mailing Address - Phone:910-322-9601
Mailing Address - Fax:
Practice Address - Street 1:370 TANYARD RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-1554
Practice Address - Country:US
Practice Address - Phone:540-488-5636
Practice Address - Fax:888-808-3395
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0906008631101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor