Douglas Kawka, PSY.D., BCB

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Practice address

414 Paoli Pike
Malvern, PA 19355-3311

Phone

(484) 596-5430

NPI assigned

Oct 1, 2015

Last updated

Sep 23, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD
• Springfield Psychological PC

  dba Associates of Springfield Psychological

  • Mental Health Counselor
  • Springfield, PA
  • NPI 1295705317
  NPD
• Healthy Synergy Psychological Services, LLC

  • Clinical Psychologist
  • Germantown, MD
  • NPI 1184970733
  NPD (past)
• Healthy Synergy Psychological Services, LLC

  • Clinical Psychologist
  • Germantown, MD
  • NPI 1578933206
  NPD (past)

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1477923506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 PAOLI PIKE",
            "address_2": "PSYCHOLOGY DEPARTMENT",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "19355",
            "telephone_number": "484-596-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 PAOLI PIKE",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193553311",
            "telephone_number": "484-596-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWKA",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "PSY.D., BCB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-01",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Johnson LLC (Family Care Chiropractic and Wellness Center)
• Sydney Louise Kamentz, DC
• Randall H Kane, O.D.
• Craig Kauffman
• Adam B Kaufman, MD
• Alexandria Kazandjian
• Alan S Keller, MD
• Justin Daniel Keller, BSN, RN
• Rosemary B. Keller, NP-C
• Michael Eugene Kelly, RPH

• Clinical Child & Adolescent Psychologist in Malvern, PA
• Providers in Malvern, PA by specialty
• Clinical Child & Adolescent Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.