Counseling and Nutrition Center 360, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1024 Issued in MA

Legal business name

COUNSELING AND NUTRITION CENTER 360, LLC

Practice address

373 Highland Ave
Suite 201
Somerville, MA 02144-2553

Phone

(781) 674-1189

Fax

(781) 863-2646

NPI assigned

Sep 17, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Elizabeth Marie Pearl, M.S., R.D., L.D.N.

Title

Owner

Phone

(781) 674-1189

Specialties & licenses 1

Addresses

Other names 1

• CNC360, LLC Doing business as

Tax ID family

Cnc3602 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Counseling and Nutrition Center 360, LLC

  • Mental Health Counselor
  • Lexington, MA
  • NPI 1477921781
  NPD tax ID

Locations

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1255767745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 BEDFORD ST",
            "address_2": "SUITE 20",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024204319",
            "telephone_number": "781-674-1189",
            "fax_number": "781-863-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 HIGHLAND AVE",
            "address_2": "SUITE 201",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442553",
            "telephone_number": "781-674-1189",
            "fax_number": "781-863-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING AND NUTRITION CENTER 360, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "PEARL",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-674-1189",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S., R.D., L.D.N."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "1024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CNC360, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joanne Costantino, PT
• Lisa Costanzo, OT
• Sabrina Cottone
• Karyn Beth Coughlin, MA
• Linda Coultas, PT
• Counseling in the Square
• Kimberly Elizabeth Covey
• Beth Cowett, LICSW
• Andrew M. Cox
• Allison Coxon

• Registered Dietitian in Somerville, MA
• Providers in Somerville, MA by specialty
• Registered Dietitian in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.