Provider Demographics
NPI:1215956362
Name:GOVENER, DAVID LLOYD (MDIV, PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LLOYD
Last Name:GOVENER
Suffix:
Gender:M
Credentials:MDIV, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LURAY DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-6602
Mailing Address - Country:US
Mailing Address - Phone:318-345-0424
Mailing Address - Fax:318-345-0425
Practice Address - Street 1:108 FILHIOL AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-3828
Practice Address - Country:US
Practice Address - Phone:318-343-3316
Practice Address - Fax:318-343-3851
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
LALPC2775101YP2500X
LALMFT492106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist