Carly Anne Leusner, MS

Primary specialty

NutritionistTaxonomy code 133N00000X

Practice address

48 Trouble St
Cummington, MA 01026-9709

Phone

(413) 588-6881

NPI assigned

Feb 3, 2023

Last updated

Feb 3, 2023By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 1, 2023 through Dec 1, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Hyman Integrative Therapies

  dba The UltraWellness Center

  • Integrative Medicine Physician
  • Lenox, MA
  • NPI 1508563594
  NPD (past)

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1073219853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 TROUBLE ST",
            "city": "CUMMINGTON",
            "state": "MA",
            "postal_code": "010269709",
            "telephone_number": "413-588-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 TROUBLE ST",
            "city": "CUMMINGTON",
            "state": "MA",
            "postal_code": "010269709",
            "telephone_number": "413-588-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUSNER",
        "first_name": "CARLY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cummington Fire Association, Inc
• Jonathan N Ginzberg, LIC. AC.
• Kyle Jensen, M.ED, LADCI
• Heather Johnson
• Lucy Leete, RN
• Suzanne Lynne Macaluso, LICSW, LADC1, CCM
• Kathy A McMahon, PSY.D.
• Mosaic Minds Mental Health Counseling LLC
• Paula Zindler RN Ibclc
• Elizabeth Eve Short, LICSW

• Nutritionist in Cummington, MA
• Providers in Cummington, MA by specialty
• Nutritionist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.