Active NPI
Lynaire McGovern, LMFT-LICENSED MARRIA
- Marriage & Family Therapist
- Oakland, CA
National Provider Identifier
1629362769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 52148
- Practice address
- 5332 College Ave
# 205
Oakland, CA 94518-2226 - Phone
- (510) 470-0063
- NPI assigned
- Jun 7, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFTI 57794 | CA | |
| Marriage & Family Therapist | 106H00000X | #52148 | CA | |
| Marriage & Family Therapist | 106H00000X | 52148 | CA | Primary |
| Counselor | 101Y00000X | 450 | CA |
Addresses
Primary practice location
5332 College Ave
# 205
Oakland, CA 94518-2226
Mailing address
1727 Dalessi Dr
Pinole, CA 94564-2226
Phone (510) 451-1125
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| #52148 | CA | MD | Marriage & Family Therapist |
| MFTI 57794 | CA | MD | Marriage & Family Therapist |
| 52148 | CA | MD | Physical Therapy Assistant |
| 450 | CA | MD | EEG Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383696000000",
"number": "1629362769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1727 DALESSI DR",
"city": "PINOLE",
"state": "CA",
"postal_code": "945642226",
"telephone_number": "510-451-1125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5332 COLLEGE AVE",
"address_2": "# 205",
"city": "OAKLAND",
"state": "CA",
"postal_code": "945182226",
"telephone_number": "510-470-0063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGOVERN",
"first_name": "LYNAIRE",
"name_prefix": "Ms.",
"credential": "LMFT-LICENSED MARRIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-07",
"last_updated": "2013-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFTI 57794",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "#52148",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "52148",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": "450",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.