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Individual

BRIAN THOMAS MCGOVERN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LCSW

Contact information

Practice address
365 MATHER ST, UNIT 132, HAMDEN, CT 06514-3148
(203) 685-7556
Mailing address
635 MAIN ST, ATTN: CREDENTIALING DEPARTMENT, MIDDLETOWN, CT 06457-2718
(860) 347-6971
(860) 638-6601

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004236346
CT
Enumeration date
10/16/2008
Last updated
07/21/2016
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