Provider Demographics
NPI:1932975679
Name:GOFMAN THERAPY AND CONSULTING PLLC
Entity Type:Organization
Organization Name:GOFMAN THERAPY AND CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GOFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-521-4311
Mailing Address - Street 1:5917 MONET DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-5277
Mailing Address - Country:US
Mailing Address - Phone:203-521-4311
Mailing Address - Fax:
Practice Address - Street 1:5917 MONET DR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-5277
Practice Address - Country:US
Practice Address - Phone:203-521-4311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty