MCGOVERN PSYCHOTHERAPY LLC NPI 1053979435

NPI Information

NPI: 1053979435
Provider Name: MCGOVERN PSYCHOTHERAPY, LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
3340 REPUBLIC AVE STE 120
ST LOUIS PARK, MN
ZIP 55426
Phone: (612) 564-8897
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MCGOVERN PSYCHOTHERAPY, LLC is a mental health (including community mental health center) clinic center in St Louis Park, MN. MCGOVERN PSYCHOTHERAPY, LLC NPI is 1053979435. The provider is registered as an organization entity type.

The provider's business location address is:

3340 REPUBLIC AVE STE 120
ST LOUIS PARK, MN
ZIP 55426-189
Phone: (612) 564-8897

The provider's authorized official is Amanda Rachel Mcgovern .
The authorized official title is Owner and has the following contact phone number (551) 486-5221.

The enumeration date for this NPI number is 5/31/2019 and was last updated on 5/31/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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