Tracy Lynn Mahloch Kadavy, PSY. D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

791 Issued in NE

Practice address

4535 Normal Blvd Ste 212
Lincoln, NE 68506-2891

Phone

(402) 322-2419

Fax

(402) 434-9299

NPI assigned

Jan 7, 2010

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Family Center Counseling

  • Clinical Psychologist
  • Falls Church, VA
  • NPI 1881872505
  NPD (past)
• The Family Center Counseling Associates PLLC

  • Professional Counselor
  • Falls Church, VA
  • NPI 1861571507

  Clinical

  NPD (past)

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

{
    "created_epoch": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1700116134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 NORMAL BLVD STE 212",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062891",
            "telephone_number": "402-322-2419",
            "fax_number": "402-434-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 NORMAL BLVD STE 212",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062891",
            "telephone_number": "402-322-2419",
            "fax_number": "402-434-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADAVY",
        "first_name": "TRACY",
        "middle_name": "LYNN MAHLOCH",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-07",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004202",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NE",
            "license": "791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Callie Rae Kacvinsky
• Blake Shareene Kadavy
• Laura S Kadavy
• Michaela Irene Kadavy
• Thomas Lee Kadavy
• Adam T. Kafka, M.D.
• Sunday Leah Kafka
• Elizabeth Calvert Kagan, M.A., CCC-SLP
• Lawrence Kagan, PH.D.
• Melissa Kahle, PT

• Clinical Psychologist in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Clinical Psychologist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.