Individual provider Active NPI

Dakota Lynn Staves, LICENSED MASSAGE THE

  • Behavior Technician
  • Freeland, MI
National Provider Identifier
1497415541
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3949 N River Rd
Freeland, MI 48623-8856
Phone
(989) 702-2082
NPI assigned
Dec 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 7501015942 MI
Technician 374700000X
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

3949 N River Rd
Freeland, MI 48623-8856

Mailing address

3949 N River Rd
Freeland, MI 48623-8856
Phone (989) 702-2082

Other practice location 1

526 W. Genesee Street
Suite 4
Frankenmuth, MI 48734
Phone (989) 652-2577

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7501015942MIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mi Chiro Corporation CurrentSince Jan 1, 2024 Accepting new patients
Spectrum Autism Center Behavior Technician PastSince Jan 19, 2025 Accepting new patients
Spectrum Autism Center LLC PastSince Jan 19, 2025 Accepting new patients

Locations

526 W Genesee St
Ste 4
Frankenmuth, MI 48734
Phone (989) 652-2577

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1497415541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 N RIVER RD",
            "city": "FREELAND",
            "state": "MI",
            "postal_code": "486238856",
            "telephone_number": "989-702-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 N RIVER RD",
            "city": "FREELAND",
            "state": "MI",
            "postal_code": "486238856",
            "telephone_number": "989-702-2082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "526 W. Genesee Street",
            "address_2": "Suite 4",
            "address_purpose": "LOCATION",
            "city": "Frankenmuth",
            "state": "MI",
            "postal_code": "48734",
            "country_code": "US",
            "telephone_number": "989-652-2577",
            "fax_number": "989-652-4776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAVES",
        "first_name": "DAKOTA",
        "middle_name": "LYNN",
        "credential": "LICENSED MASSAGE THE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-29",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501015942",
            "primary": false
        },
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.