Individual provider Active NPI

Daniel M Kavanaugh, MSW, LCSW-C

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1336416544
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC50079241 Issued in DC
Practice address
5100 Wisconsin Ave NW
Suite 300
Washington, DC 20016-4119
Phone
(202) 244-8855
NPI assigned
Nov 17, 2011
Last updated
Nov 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC50079241 DC Primary
Clinical Social Worker 1041C0700X 07995 MD

Addresses

Primary practice location

5100 Wisconsin Ave NW
Suite 300
Washington, DC 20016-4119

Mailing address

5100 Wisconsin Ave NW
Suite 300
Washington, DC 20016-4119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC50079241DCMDClinical Social Worker
07995MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1336416544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 WISCONSIN AVE NW",
            "address_2": "SUITE 300",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200164119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 WISCONSIN AVE NW",
            "address_2": "SUITE 300",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200164119",
            "telephone_number": "202-244-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "DANIEL",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-17",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50079241",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "07995",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.