| Doctor Name: | DR. JOHN JOSEPH MCGOVERN |
| NPI Number: | 1316225832 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW, PH.D. |
| License Number: | R028623 |
| Business Practice Address: | 283 Springs Fireplace Rd East Hampton, NY - 119374823 |
| Business Phone Number: | 6313290373 |
| Business Fax Number: | |
| Mailing Address: | 37 Primrose Ln, KINGS PARK |
| State: | NY |
| Postal Code: | 117543931 |
| Phone Number: | 6313600172 |
| Fax Number: | |
| NPI Enumeration Date: | 08/01/2011 |
| NPI Last Update Date: | 08/01/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | R028623 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |