Goal Succeeders

Primary specialty

Adult CompanionTaxonomy code 372600000X

Legal business name

GOAL SUCCEEDERS

Practice address

4401 Virginia Beach Blvd
Virginia Beach, VA 23462-3106

Phone

(757) 800-7806

NPI assigned

Dec 20, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chaz Lamar Clyburn, PSS, CPCNPI 1346886504

Title

Certified Peer Counselor

Phone

(757) 800-7806

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• GOAL Succeeders Former legal business name

Electronic endpoints 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chaz Lamar Clyburn

  • Adult Companion
  • Virginia Beach, VA
  • NPI 1346886504

  Single Specialty

  NPD Authorized official
• Ashley Nicole Robinson, PCC

  • Home Delivered Meals
  • Virginia Beach, VA
  • NPI 1376115204
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1576800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576800000000",
    "number": "1184263113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5217 SHADY GROVE LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621787",
            "telephone_number": "757-800-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623106",
            "telephone_number": "757-800-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOAL SUCCEEDERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-20",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A",
        "authorized_official_last_name": "CLYBURN",
        "authorized_official_first_name": "CHAZ",
        "authorized_official_middle_name": "LAMAR",
        "authorized_official_title_or_position": "CERTIFIED PEER COUNSELOR",
        "authorized_official_telephone_number": "757-800-7806",
        "authorized_official_credential": "PSS, CPC"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "YTF885133438",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Https://goalsucceeders2021.simdif.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4401 Virginia Beach Blvd",
            "city": "Virginia Beach",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234623106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "GOAL Succeeders",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Shelby Payton Glover
• Susan Lynn Glover, LPC
• Anisa Glowczak, LPC, NCC, GC-C, PT-C
• Gma Interventions, LLC
• GMC Transportation LLC
• Talar Nicole Gober
• Yvonne Yngson Gochangco, M.S.N., CRNA
• Shamika Godbold
• Adam Reinhold Goddard, MD
• Catherine Chioma Godfrey

• Adult Companion in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Adult Companion in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.