Lifestyle Massage Therapy LLC

Key facts

NPI

1225730278

Entity type

Organization (NPI type 2)

Primary specialty

Health Service Clinic/Center 261QH0100X

Legal business name

LIFESTYLE MASSAGE THERAPY LLC

Practice address

4873 Manhattan Dr
Rockford, IL 61108-2265

Phone

(815) 977-5876

Fax

(855) 509-0419

NPI assigned

Mar 21, 2023

Organization subpart

No

Authorized official

Name

Christy A Cellitti, LMT NPI 1558980797

Title

Owner

Phone

(815) 977-5876

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christy Ann Cellitti, LMT Massage Therapist · Rockford, IL · NPI 1558980797
  NPD Authorized official MASSAGE THERAPIST

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 21, 2023.

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1225730278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4873 MANHATTAN DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082265",
            "telephone_number": "815-977-5876",
            "fax_number": "855-509-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4873 MANHATTAN DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082265",
            "telephone_number": "815-977-5876",
            "fax_number": "855-509-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE MASSAGE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "CELLITTI",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-977-5876",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "173C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Reflexologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Rockford, IL · Health Service Clinic/Center in Illinois