Individual provider Active NPI

Tiffany M. Kavanaugh, LCSW

  • Clinical Social Worker
  • Lincoln, NE
National Provider Identifier
1124102827
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
424 Issued in NE
Practice address
3901 Faulkner Dr
Lincoln, NE 68516-4738
Phone
(402) 875-9270
Fax
(402) 875-9272
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 424 NE Primary

Addresses

Primary practice location

3901 Faulkner Dr
Lincoln, NE 68516-4738

Mailing address

3901 Faulkner Dr
Lincoln, NE 68516-4738
Phone (402) 875-9270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • 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
I20040923000730 NE Practitioner - Clinical Social Worker 6002884350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3701 Union Dr
Suite 100
Lincoln, NE 68516-6629
Phone (402) 875-9270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1011NEMDOccupational Therapy Assistant
424NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tiffany M Kavanaugh LCSW LLC Clinical CurrentSince Jul 31, 2008 Accepting new patients

Locations

3901 Faulkner Dr
Lincoln, NE 68516
Phone (402) 464-2422

3600 Village Dr
Ste 110
Lincoln, NE 68516

3701 Union Dr
Ste 100
Lincoln, NE 68516
Phone (402) 205-5677

Organizations & group practices 1

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1124102827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 FAULKNER DR",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164738",
            "telephone_number": "402-875-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 FAULKNER DR",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164738",
            "telephone_number": "402-875-9270",
            "fax_number": "402-875-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "TIFFANY",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.