Provider Demographics
NPI:1437675212
Name:GOVIG, COURTNEY (LPCC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:GOVIG
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:SCHANER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPPC
Mailing Address - Street 1:4830 E ROUND UP
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503
Mailing Address - Country:US
Mailing Address - Phone:701-426-1703
Mailing Address - Fax:888-901-7234
Practice Address - Street 1:515 1/2 E BROADWAY AVENUE SUITE 106
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501
Practice Address - Country:US
Practice Address - Phone:701-751-0443
Practice Address - Fax:701-751-1616
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1016-8-1-19A101YP2500X
ND1016-8-1-19-445101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1528309846Medicaid
ND1480330Medicaid