MEDICARE: LARITA GOFORTH SLP

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	235Z00000X	Speech-Language Pathologist	S2941	MS

General Provider Information

NPI Number	:	1205129889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARITA GOFORTH SLP

Provider Business Mailing Address
First Line	:	4109 HIGHWAY 98 W
Second Line	:
City	:	SUMMIT
State	:	MS
Zip	:	39666-9132
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1129 HIGHWAY 35 S STE 2
Second Line	:
City	:	FOREST
State	:	MS
Zip	:	39074-8829
Country	:	US
Telephone Number	:	601-469-1001
Fax Number	:

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

Provider Enumeration Date	:	05/16/2011
Last Update Date	:	12/11/2018

Similar Medicare Providers

1598968802 — MYNA LAQUISHA BURKS M.S. SLP-CCC
Practice Location Address:

1129 HIGHWAY 35 S STE 2
FOREST, MS
39074-8829

Practice Phone: 601-469-1001
Practice Fax:

1174892822 — CLAUDIA BOWMAN
Practice Location Address:

1123 HIGHWAY 35 S
FOREST, MS
39074-8829

Practice Phone: 601-469-4771
Practice Fax: 601-469-4724

1154670719 — INDEPENDENT HEALTHCARE MANAGEMENT, INC.
Practice Location Address:

1129 HIGHWAY 35 S , SUITE 1
FOREST, MS
39074-8829

Practice Phone: 601-849-6440
Practice Fax: 601-849-1318

1487093811 — ADRIENNE BAUGH OT
Practice Location Address:

1151 HIGHWAY 35 S
FOREST, MS
39074-8829

Practice Phone: 601-469-2732
Practice Fax:

1629403704 — COREY L SHOEMAKER
Practice Location Address:

1123 HIGHWAY 35 S
FOREST, MS
39074-8829

Practice Phone: 601-469-4771
Practice Fax:

1457739849 — HALEY HUEY PURVIS SLP
Practice Location Address:

1129 HIGHWAY 35 S STE 2
FOREST, MS
39074-8829

Practice Phone: 601-469-1001
Practice Fax: 601-469-1009

Directions to “ LARITA GOFORTH SLP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.