Individual provider Active NPI

Juliane Lee McGovern, LCMHC, MLADC

  • Mental Health Counselor
  • Manchester, NH
National Provider Identifier
1124400999
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1220 Issued in NH
Practice address
2013 Elm Street
Manning House
Manchester, NH 03104-2528
Phone
(603) 627-2702
Fax
(603) 627-3643
NPI assigned
Jun 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1150 NH
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 1220 NH Primary

Addresses

Primary practice location

2013 Elm Street
Manning House
Manchester, NH 03104-2528

Mailing address

2013 Elm Street
Manning House
Manchester, NH 03104-2528
Phone (603) 627-2702

Other names 1

  • Juliane Theriault Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TheMentalHealthCenterofGreaterManchester@mhcgm.netsmartdirect.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240213000894 NH Practitioner - Mental Health Counselor 2961845383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2013 Elm St
Manchester, NH 03104-2528
Phone (603) 627-2702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1150NHMDPsychologist
1220NHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brightleaf, Inc CurrentSince Jan 2, 2024 Accepting new patients
The Mental Health Center of Greater Manchester PastSince Jul 28, 2010 Accepting new patients

Locations

2013 Elm St
Manchester, NH 03104
Phone (603) 627-2702

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1124400999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 ELM STREET",
            "address_2": "MANNING HOUSE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042528",
            "telephone_number": "603-627-2702",
            "fax_number": "603-627-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 ELM STREET",
            "address_2": "MANNING HOUSE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042528",
            "telephone_number": "603-627-2702",
            "fax_number": "603-627-3643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "JULIANE",
        "middle_name": "LEE",
        "credential": "LCMHC, MLADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2024-01-09",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NH",
            "license": "1150",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "1220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TheMentalHealthCenterofGreaterManchester@mhcgm.netsmartdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2 Wall St",
            "address_2": "Ste 400",
            "city": "Manchester",
            "state": "NH",
            "country_code": "US",
            "postal_code": "031011518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JULIANE",
            "last_name": "THERIAULT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.