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NPI Code Detail

MEDICARE: CARRIE MCGOVERN BA

MEDICARE: CARRIE MCGOVERN BA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2171M00000XCase Manager/Care Coordinator
3174400000XSpecialist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609213370
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE MCGOVERN BA
Provider Business Mailing Address
First Line : 29 SCHOOL ST
Second Line :
City : CONCORD
State : NH
Zip : 03301-4033
Country : US
Telephone Number : 603-226-7505
Fax Number :
Provider Business Practice Location Address
First Line : 105 LOUDON RD BLDG 3
Second Line :
City : CONCORD
State : NH
Zip : 03301-5600
Country : US
Telephone Number : 603-228-0547
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2013
Last Update Date : 06/01/2026

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