Lourdes Mae Kavanagh, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27800 Issued in MN

Practice address

410 30TH Ave E
Alexandria, MN 56308-4769

Phone

(320) 255-6322

NPI assigned

Oct 28, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Lakeland Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fergus Falls, MN
  • NPI 1366480287
  NPD (past)

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1649870668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 30TH AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084769",
            "telephone_number": "320-556-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 30TH AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084769",
            "telephone_number": "320-255-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAGH",
        "first_name": "LOURDES",
        "middle_name": "MAE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "27800",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "27800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ka Bloomquist RG Bakewell OD PA (Eye Associates of Alexandria)
• Kalon Prep Academy
• Pamela Marie Kamholz, RN
• Hannah Katnis, LPCC, LADC
• Jenna L Kavanagh, LADC
• Terry Jo Kay, PA-C
• Thomas Scott Keene, OD
• Patrice L Keipe, HYGIENIST
• Ashley Kellen
• Terence James Kennedy, MD

• Clinical Social Worker in Alexandria, MN
• Providers in Alexandria, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.