Individual provider Active NPI

Michael Kavkewitz, PH. D.

  • Clinical Psychologist
  • Chattanooga, TN
National Provider Identifier
1598814394
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
864 Issued in GA
Practice address
6727 Heritage Business CT
Suite 724
Chattanooga, TN 37421-7015
Phone
(423) 314-1176
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 864 GA Primary
Counseling Psychologist 103TC1900X P001108 TN

Addresses

Primary practice location

6727 Heritage Business CT
Suite 724
Chattanooga, TN 37421-7015

Mailing address

103 Tuxedo Cir
Chattanooga, TN 37411-4618

Other identifiers 2

IdentifierTypeStateIssuer
0090222OtherTNBCBS-TN PROVIDER ID
00389914DMedicaidGA

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
864GAMDClinical Psychologist
P001108TNMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1598814394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 TUXEDO CIR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374114618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6727 HERITAGE BUSINESS CT",
            "address_2": "SUITE 724",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374217015",
            "telephone_number": "423-314-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVKEWITZ",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "864",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TN",
            "license": "P001108",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-TN PROVIDER ID",
            "identifier": "0090222",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00389914D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.