MARY ELIZABETH KAVANAUGH M.A
NPI 1558509547
Marriage & Family Therapist in Santa Clara, CA

Q: What is Mary Kavanaugh's NPI number?

The NPI number for Mary Kavanaugh is 1558509547. It was assigned to this individual provider in the NPPES registry on January 28, 2009.

Q: What is Mary Kavanaugh's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Kavanaugh was last updated on February 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since January 28, 2009PECOS Enrolled

3840 HOMESTEAD RD, SANTA CLARA, CA 95051(916) 955-6254 Get Directions Write a Review

NPPES record last updated: February 11, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 11, 2022, Jan 19, 2017, Dec 19, 2016 (3 updates tracked since 2016).

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About Mary Elizabeth Kavanaugh M.a NPPES

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

MARY ELIZABETH KAVANAUGH M.A (NPI 1558509547) is an individual marriage & family therapist in Santa Clara, California, licensed in California (90282) and active in the NPI registry since January 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558509547

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameMARY ELIZABETH KAVANAUGHCredential: M.A

Location Address3840 HOMESTEAD RDSanta Clara, CA 95051-4542

Mailing Address3840 Homestead RdSanta Clara, CA 95051-4542 · (916) 955-6254

Phone(916) 955-6254

Sole ProprietorYes

Enumeration DateJanuary 28, 2009

Last NPPES UpdateFebruary 11, 20223 updates tracked since enumeration

✔ NPI 1558509547 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 90282

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

3840 HOMESTEAD RD, Santa Clara, CA 95051

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Other Identifiers 1

Other90282CA · Board Of Behavioral Sciences

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Elizabeth Kavanaugh M.a is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHANIE HELEN SCHULTZE PONCE

Marriage & Family Therapist