Individual provider Active NPI

Dahlia Michelle Lavery, LMFT

  • Marriage & Family Therapist
  • San Francisco, CA
National Provider Identifier
1871953307
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
111250 Issued in CA
Practice address
1801 Vicente St
San Francisco, CA 94116-2923
Phone
(415) 681-3211
NPI assigned
Feb 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 111250 CA Primary

Addresses

Primary practice location

1801 Vicente St
San Francisco, CA 94116-2923

Mailing address

1801 Vicente St
San Francisco, CA 94116-2923
Phone (415) 681-3211

Other names 1

  • Dahlia Michelle Gross Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
111250CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1871953307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 VICENTE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162923",
            "telephone_number": "415-681-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 VICENTE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162923",
            "telephone_number": "415-681-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVERY",
        "first_name": "DAHLIA",
        "middle_name": "MICHELLE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-25",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "111250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAHLIA",
            "last_name": "GROSS",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.