Active NPI
Kenya Denise Govan
- Behavior Technician
- Carbondale, IL
National Provider Identifier
1295422657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1101 E Grand Ave Apt X3
Carbondale, IL 62901-3516 - Phone
- (618) 521-3928
- NPI assigned
- Apr 18, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1101 E Grand Ave Apt X3
Carbondale, IL 62901-3516
Mailing address
1101 E Grand Ave Apt X3
Carbondale, IL 62901-3516
Phone (618) 521-3928
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681776000000",
"number": "1295422657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 E GRAND AVE APT X3",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629013516",
"telephone_number": "618-521-3928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 E GRAND AVE APT X3",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629013516",
"telephone_number": "618-521-3928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOVAN",
"first_name": "KENYA",
"middle_name": "DENISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-18",
"last_updated": "2023-04-18",
"certification_date": "2023-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carbondale, IL
- Wallace Adam Goforth, CRNA
- Bryan M Goldesberry, DMD
- Portia Goodin, MA, CCC-SLP
- Theresa Aleise Goodin, MA-CCC-SLP
- Katie Ann Gossett, FNP-C
- Susan Elizabeth Grace, LCSW
- Sandhya Rani Grandhi
- Granite City Emergency Medicine Providers LLC
- Granite City Hospitalist Services LLC
- Leigh Karole Grannan, M.S., BCBA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.