Individual provider Active NPI

Lynaire McGovern, LMFT-LICENSED MARRIA

  • Marriage & Family Therapist
  • Oakland, CA
National Provider Identifier
1629362769
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
52148 Issued in CA
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

Updated by the provider on Nov 6, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
#52148CAMDMarriage & Family Therapist
MFTI 57794CAMDMarriage & Family Therapist
52148CAMDPhysical Therapy Assistant
450CAMDEEG 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.

Verify at the official NPI Registry.