Individual
DR. JAMES M MCGOVERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1023 MANATEE AVE W STE 302, BRADENTON, FL 34205-7816
(941) 405-6413
(941) 216-3323
Mailing address
1023 MANATEE AVE W STE 302, BRADENTON, FL 34205-7816
(941) 405-3614
(941) 216-3323
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY4238
FL
103T00000X
Psychologist
PY4238
FL
103TB0200X
Cognitive & Behavioral Psychologist
PY4238
FL
103TC0700X
Clinical Psychologist
PY4238
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY4238
FL
103TF0200X
Forensic Psychologist
PY4238
FL
103TH0100X
Health Service Psychologist
PY4238
FL
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PY4238
FL
103TR0400X
Rehabilitation Psychologist
PY4238
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680010165
RAIL ROAD MEDICARE
FL
01
—
73532
BCBS
FL
Enumeration date
09/19/2005
Last updated
07/21/2022
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