Healthcare Provider Details

I. General information

NPI: 1689409021
Provider Name (Legal Business Name): MS. RACHEL MCGOVERN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 PLEASANT ST BLDG A
WATERTOWN MA
02472-2463
US

IV. Provider business mailing address

480 PLEASANT ST BLDG A
WATERTOWN MA
02472-2463
US

V. Phone/Fax

Practice location:
  • Phone: 617-272-9045
  • Fax: 617-360-3342
Mailing address:
  • Phone: 617-272-9045
  • Fax: 617-360-3342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: