Individual provider Active NPI

Kavitha Dharmalingam Venkateswaran, PHD

  • Psychologist
  • Milwaukee, WI
National Provider Identifier
1023655362
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
2675 N Mayfair Rd Ste 400
Milwaukee, WI 53226-1305
Phone
(414) 763-6910
Fax
(414) 763-6911
NPI assigned
Dec 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 3742-57 WI
Psychologist 103T00000X Primary
Clinical Psychologist 103TC0700X 3742-57 WI

Addresses

Primary practice location

2675 N Mayfair Rd Ste 400
Milwaukee, WI 53226-1305

Mailing address

2675 N Mayfair Rd Ste 400
Milwaukee, WI 53226-1305
Phone (414) 763-6910

Other practice location 1

5000 W National Ave
Milwaukee, WI 53295-0001
Phone (440) 384-2000 ext. 41213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221216002040 WI Practitioner - Clinical Psychologist 9638548472 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3742-57WIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
New Frontiers TMS LLC CurrentSince Dec 13, 2022 Accepting new patients
New Frontiers Psychiatric SC Psychologist CurrentSince Dec 15, 2022 Accepting new patients

Locations

2675 N Mayfair Rd
Ste 400
Milwaukee, WI 53226
Phone (414) 350-2449

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1023655362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 N MAYFAIR RD STE 400",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532261305",
            "telephone_number": "414-763-6910",
            "fax_number": "414-763-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 N MAYFAIR RD STE 400",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532261305",
            "telephone_number": "414-763-6910",
            "fax_number": "414-763-6911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 W National Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532950001",
            "country_code": "US",
            "telephone_number": "440-384-2000 x41213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENKATESWARAN",
        "first_name": "KAVITHA",
        "middle_name": "DHARMALINGAM",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-05",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WI",
            "license": "3742-57",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3742-57",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.