Mark Joseph McGowan Sr.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CI34461221 Issued in CA

Practice address

83912 Avenue 45 Ste 9
Indio, CA 92201-3338

Phone

(760) 347-0754

NPI assigned

Aug 24, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• County of Riverside

  • Community/Behavioral Health Agency
  • Indio, CA
  • NPI 1134295702
  NPD (past)
• Mental Health Substance Abuse Program

  • Community/Behavioral Health Agency
  • Indio, CA
  • NPI 1568604452
  NPD (past)

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1184343063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3051",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922023051",
            "telephone_number": "760-699-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83912 AVENUE 45 STE 9",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922013338",
            "telephone_number": "760-347-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-24",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CI34461221",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE",
            "identifier": "CI34461221",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "sobriety.1.15@gmail.com",
            "affiliation": "N",
            "endpointDescription": "I do not have secure network yet.  Need my NPI number first",
            "address_1": "47470 Van Buren St",
            "city": "Indio",
            "state": "CA",
            "country_code": "US",
            "postal_code": "922017139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alma Delia McClanahan, RN
• Nina Lynn McClinton
• Sarah Janelle McCracken
• Devin Jon McDonald, CADC I
• Jade Elizabeth McGarry
• Kathleen Marie McIntosh
• Aisha Liana McKee
• Jasen A McKenrick
• Leanna McKeough, LVN
• Chyanne Elena McKinley

• Addiction (Substance Use Disorder) Counselor in Indio, CA
• Providers in Indio, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.