Individual provider Active NPI

Patrick McGovern Jr., LLMFT; RSST

  • Marriage & Family Therapist
  • Flint, MI
National Provider Identifier
1508110685
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4101006538 Issued in MI
Practice address
765 E Hamilton Ave
Flint, MI 48505-4707
Phone
(810) 233-5340
NPI assigned
Oct 29, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4101006538 MI Primary

Addresses

Primary practice location

765 E Hamilton Ave
Flint, MI 48505-4707

Mailing address

1153 Woodnoll Dr
Flint, MI 48507-4711
Phone (810) 249-0205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240806004290 MI Practitioner - Mental Health Counselor 2365989407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Paths, IncGroup PAC ID 2860806247, 6 clinicians

Practice addresses (Care Compare)

765 E Hamilton Ave
Flint, MI 48505-4707
Phone (810) 233-5340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4101006538MIMDMarriage & Family Therapist

Organizations & group practices 1

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": "1351468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1508110685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 WOODNOLL DR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485074711",
            "telephone_number": "810-249-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 E HAMILTON AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485054707",
            "telephone_number": "810-233-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "PATRICK",
        "name_suffix": "Jr.",
        "credential": "LLMFT; RSST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-29",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101006538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.