Candida Michelle Cosentino, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

227.022776 Issued in IL

Practice address

250 Main St
Sugar Grove, IL 60554-5443

Phone

(844) 762-0735

NPI assigned

Nov 17, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 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 and National Provider Directory roles.

• Axon Bodywork Therapies LLC

  • Massage Therapist
  • Elburn, IL
  • NPI 1366204000
  NPD Authorized official

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1386353449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 SURREY CT",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064447",
            "telephone_number": "331-806-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MAIN ST",
            "city": "SUGAR GROVE",
            "state": "IL",
            "postal_code": "605545443",
            "telephone_number": "844-762-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSENTINO",
        "first_name": "CANDIDA",
        "middle_name": "MICHELLE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-17",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IN",
            "license": "MT22207844",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227.022776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "candi@axontherapy.org",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "250 Main St",
            "city": "Sugar Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605545443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle Linnae Byrd
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• Paul Copps, DO
• Suzanne Creedon, R.K.T.
• Cynthia G Slocum MSW LCSW PC
• Katherine Dolewski, MSW, LCSW
• Donald J Fee DDS LTD
• Jennifer Dotter, PTA

• Massage Therapist in Sugar Grove, IL
• Providers in Sugar Grove, IL by specialty
• Massage Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.