Lavina Cereris Dickinson, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

162301 Issued in AK

Practice address

10708 Lupine Cir
Seward, AK 99664-1981

Phone

(907) 599-0534

NPI assigned

Feb 18, 2021

Last updated

Feb 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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.

• Golden Door LLC.

  dba Alchemy Wellness Collective

  • Acupuncturist
  • Seward, AK
  • NPI 1679438733

  Massage Therapist

  NPD Authorized official

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1780277947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1981",
            "city": "SEWARD",
            "state": "AK",
            "postal_code": "996641981",
            "telephone_number": "907-599-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10708 LUPINE CIR",
            "city": "SEWARD",
            "state": "AK",
            "postal_code": "996641981",
            "telephone_number": "907-599-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "LAVINA",
        "middle_name": "CERERIS",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "162301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ALASKA MASSAGE LICENSE",
            "identifier": "162301",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Brooks Crites, NP
• Jill Stanton Cross, LCSW
• Tykan Daly
• Florence Davis
• Autumn Dell
• Elizabeth Dierkes, PT, DPT
• Sara Dietrich, MAMFT
• Arthur Michael Dorame
• Dr. Michael P. Moriarty, P.C.
• Carolyn Sue Drover, LMT

• Massage Therapist in Seward, AK
• Providers in Seward, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.