McGovern Psychotherapy, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MCGOVERN PSYCHOTHERAPY, LLC

Practice address

3340 Republic Ave Ste 120
St Louis Park, MN 55426-4189

Phone

(612) 564-8897

NPI assigned

May 31, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Amanda Rachel McGovern, PH.D.

Title

Owner

Phone

(551) 486-5221

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559260800000",
    "number": "1053979435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 REPUBLIC AVE STE 120",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 REPUBLIC AVE STE 120",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264189",
            "telephone_number": "612-564-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCGOVERN PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-05-31",
        "status": "A",
        "authorized_official_last_name": "MCGOVERN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "RACHEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "551-486-5221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen M McDonald
• Karen McEiver, PHARM.D.
• Rory James Lee McFarlane
• Barbara Ruedy McGlynn, P.T.
• Sara McGlynn
• Fiona McGovern
• John McGreevy
• Ann T McIntosh, MD
• Julie Anne McKay, PSYD
• Marisa Kaye McKeever, DNP

• Mental Health Clinic/Center (Including Community Mental Health Center) in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.