Samantha Alyssa McGovern

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.015354 Issued in IL

Practice address

2 Wheaton Ctr Apt 1001
Wheaton, IL 60187-4972

Phone

(630) 639-6594

NPI assigned

Nov 20, 2017

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

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Life Care Wellness, Inc.

  • Professional Counselor
  • Glen Ellyn, IL
  • NPI 1952767733
  Medicare reassignment NPD

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1871007476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WHEATON CTR APT 1001",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874972",
            "telephone_number": "630-639-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WHEATON CTR APT 1001",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874972",
            "telephone_number": "630-639-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "SAMANTHA",
        "middle_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.015354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Lynn McDowell
• Samuel McEuen, L.P.C.
• Chantelle Alicia McGee
• Zandra McGhee
• Chandra McGinnis
• Katie McGrail
• Margaret Haley McGrail, PTA
• Roberta Jean McGrath
• Tiffany E McGuire
• Nathaniel Erick McIntyre, M.D.

• Professional Counselor in Wheaton, IL
• Providers in Wheaton, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.