NPIMap

Organization Active NPI

Counseling and Nutrition Center 360, LLC

Doing business as Cnc360

  • Mental Health Counselor
  • Lexington, MA
National Provider Identifier
1477921781
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6779 Issued in MA
Legal business name
COUNSELING AND NUTRITION CENTER 360, LLC
Doing business as
Cnc360
Practice address
33 Bedford St
Suite 20
Lexington, MA 02420-4319
Phone
(781) 674-1189
Fax
(781) 863-2646
NPI assigned
Sep 3, 2015
Last updated
Sep 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

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

Authorized official

Name
Ms. Elizabeth Marie Pearl, MS, RD, LDN, CEDSNPI 1386775898
Title
Owner
Phone
(781) 674-1189

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 6779 MA Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 118496 MA

Addresses

Primary practice location

33 Bedford St
Suite 20
Lexington, MA 02420-4319

Mailing address

33 Bedford St
Suite 20
Lexington, MA 02420-4319
Phone (781) 674-1189

Other names 1

  • CNC360 Doing business as

National Provider Directory

National Provider Directory
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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1477921781",
    "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": "33 BEDFORD ST",
            "address_2": "SUITE 20",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024204319",
            "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": "2015-09-03",
        "last_updated": "2015-09-03",
        "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": "MS, RD, LDN, CEDS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "6779",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "118496",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CNC360",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.