1. Home
  2. Directory
  3. Minnesota
  4. Eden Prairie
  5. Psychologist
  6. NPI Profile

KATHLEEN MARIE KAVANAUGH MA
NPI 1154812238
Psychologist - Clinical in Eden Prairie, MN

Active since May 23, 2018
9531 W 78TH ST STE 110, EDEN PRAIRIE, MN 55344(952) 893-9791(952) 841-7069 Get Directions Write a Review

NPPES record last updated: May 23, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kathleen Marie Kavanaugh Ma NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHLEEN MARIE KAVANAUGH MA (NPI 1154812238) is an individual clinical provider in Eden Prairie, Minnesota, licensed in Minnesota (LP2468) and active in the NPI registry since May 2018.

NPPES Registry Identity

NPI1154812238
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameKATHLEEN MARIE KAVANAUGHCredential: MA
Location Address9531 W 78TH ST STE 110Eden Prairie, MN 55344-8022
Mailing Address9531 W 78th St Ste 110Eden Prairie, MN 55344-8022 · (952) 893-9791 · Fax (952) 841-7069
Phone(952) 893-9791
Fax(952) 841-7069
Sole ProprietorYes
Enumeration DateMay 23, 2018
✔ NPI 1154812238 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in MN · LP2468
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
9531 W 78TH ST STE 110, Eden Prairie, MN 55344
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kathleen Kavanaugh's NPI number?

The NPI number for Kathleen Kavanaugh is 1154812238. It was assigned to this individual provider in the NPPES registry on May 23, 2018.

Where is Kathleen Kavanaugh located?

Kathleen Kavanaugh practices at 9531 W 78th St Ste 110, Eden Prairie, MN 55344. The listed phone number is (952) 893-9791.

What is Kathleen Kavanaugh's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Kathleen Kavanaugh was last updated on May 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.