John Joseph McGovern, LCSW, PH.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R028623 Issued in NY

Practice address

283 Springs Fireplace Rd
East Hampton, NY 11937-4823

Phone

(631) 329-0373

NPI assigned

Aug 1, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Phoenix Houseof Ny, Inc.

  • Clinical Social Worker
  • East Hampton, NY
  • NPI 1710122536
  NPD (past)

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312156800000",
    "number": "1316225832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 PRIMROSE LN",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117543931",
            "telephone_number": "631-360-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 SPRINGS FIREPLACE RD",
            "city": "EAST HAMPTON",
            "state": "NY",
            "postal_code": "119374823",
            "telephone_number": "631-329-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "LCSW, PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-01",
        "last_updated": "2011-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R028623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LICENSE",
            "identifier": "R028623",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adele Stewart Macmillan, LCSW
• David Anthony Mambrino, DDS
• Lynette Marichal, S.L.P.-C.C.C.-TSLD
• Katelyn Pryal Mautschke, M.A., CCC-SLP
• Alexandra Bonney McAuliffe
• Erin M. McKay, ANP
• Natalie Meisinger, LIMITED-PERMIT MHC
• Karen Melnick, LCSW
• Luis Emilio Menjivar, L.P.N
• Nicole K Miksinski, DPT

• Clinical Social Worker in East Hampton, NY
• Providers in East Hampton, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; 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.