Tara L Govan, LCAS 1917

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1917 Issued in NC

Practice address

209 Martin Luther King Jr. Dr.
Elizabethtown, NC 28337-2833

Phone

(910) 247-6822

Fax

(910) 247-6829

NPI assigned

Oct 28, 2019

Last updated

Oct 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tara L Govan Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Omni Behavioral Services

  • Addiction (Substance Use Disorder) Counselor
  • Elizabethtown, NC
  • NPI 1083257562
  NPD

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1740823228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 MARTIN LUTHER KING JR. DR.",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283377770",
            "telephone_number": "910-247-6822",
            "fax_number": "910-247-6829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MARTIN LUTHER KING JR. DR.",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283372833",
            "telephone_number": "910-247-6822",
            "fax_number": "910-247-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOVAN",
        "first_name": "TARA",
        "middle_name": "L",
        "credential": "LCAS 1917",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "GOVAN",
            "middle_name": "L",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Luke Austin Gooden
• Stephanie Gooden, PA-C
• Julia Hall Goodwin, RPH
• Thomas Goodwin
• Goshen Medical Center, Incorporated (Goshen Medical Center - Elizabethtown)
• Ashley Ann Graham Jones, FNP-C
• Pearly Berlette Graham-Hoskins, MD
• Briana Gayle Graham, PA-C
• Donna Marie Gray
• Jamie Lynn Hammond

• Addiction (Substance Use Disorder) Counselor in Elizabethtown, NC
• Providers in Elizabethtown, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.