Tanya V Kavicky-Mels, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1086-124 Issued in WI

Practice address

301 E Saint Joseph St
Green Bay, WI 54301-2241

Phone

(920) 433-3630

Fax

(920) 437-0533

NPI assigned

Jun 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891057303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22040",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052040",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E SAINT JOSEPH ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012241",
            "telephone_number": "920-433-3630",
            "fax_number": "920-437-0533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "831 Parker Ave",
            "address_purpose": "LOCATION",
            "city": "Algoma",
            "state": "WI",
            "postal_code": "542011808",
            "country_code": "US",
            "telephone_number": "920-487-3084",
            "fax_number": "920-437-0533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "575 4th St",
            "address_purpose": "LOCATION",
            "city": "Kewaunee",
            "state": "WI",
            "postal_code": "542161785",
            "country_code": "US",
            "telephone_number": "920-433-3630",
            "fax_number": "920-388-0479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAVICKY-MELS",
        "first_name": "TANYA",
        "middle_name": "V",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "1086-124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891057303",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David K Kaufman, MD
• Jacqueline M Kaufman, AGPCNP-BC
• Ruth Kaufman, M.S., LPC
• Kendra Kaul
• Andrew D Kausak, D-PT
• Katie Ralene Kavicky, ND
• Megan A Kaye, LPC
• Rashid Kazman, M.D.
• Kindel N Keener, FNP-C
• Megan J Kees, APNP

• Marriage & Family Therapist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Marriage & Family Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.