Basic Information
| Provider Information | |||||||||
| NPI: | 1548421365 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCGOVERN | ||||||||
| FirstName: | TANYA | ||||||||
| MiddleName: | JEAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PSY.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SCHNORR | ||||||||
| OtherFirstName: | TANYA | ||||||||
| OtherMiddleName: | JEAN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1523A COLONIAL TER | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 222091400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7576472018 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8901 ROCKVILLE PIKE | ||||||||
| Address2: | |||||||||
| City: | BETHESDA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208891400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012954000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2008 | ||||||||
| LastUpdateDate: | 03/27/2019 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TA0700X | 0810003941 | VA | N | Behavioral Health & Social Service Providers | Psychologist | Adult Development & Aging | 103TB0200X | 0810003941 | VA | N | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral | 103T00000X | 0810003941 | VA | N | Behavioral Health & Social Service Providers | Psychologist | 103TC0700X | 0810003941 | VA | N | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TC2200X | 0810003941 | VA | N | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | 103TE1100X | 0810003941 | VA | N | Behavioral Health & Social Service Providers | Psychologist | Exercise & Sports | 103TF0000X | 0810003941 | VA | N | Behavioral Health & Social Service Providers | Psychologist | Family | 103TF0200X | 0810003941 | VA | N | Behavioral Health & Social Service Providers | Psychologist | Forensic | 103TH0004X | 0810003941 | VA | N | Behavioral Health & Social Service Providers | Psychologist | Health | 103TM1800X | 0810003941 | VA | N | Behavioral Health & Social Service Providers | Psychologist | Mental Retardation & Developmental Disabilities | 103TP0814X | 0810003941 | VA | N | Behavioral Health & Social Service Providers | Psychologist | Psychoanalysis | 103TP2701X | 0810003941 | VA | N | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy | 103TR0400X | 0810003941 | VA | N | Behavioral Health & Social Service Providers | Psychologist | Rehabilitation | 103G00000X | 0810003941 | VA | Y | Behavioral Health & Social Service Providers | Clinical Neuropsychologist |
No ID Information.