MEDICARE: CHERELLE GOODE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0701007023	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144757147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERELLE GOODE

Provider Business Mailing Address
First Line	:	7918 JONES BRANCH DR STE 400
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-3319
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7918 JONES BRANCH DR
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-3337
Country	:	US
Telephone Number	:	757-828-3832
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2017
Last Update Date	:	03/12/2026

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Directions to “ CHERELLE GOODE ” Practice Location

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