# COUNSELING AND NUTRITION CENTER 360, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** CNC360
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477921781
- **Authorized official:** MS. ELIZABETH MARIE PEARL MS, RD, LDN, CEDS (OWNER)
- **Authorized official phone:** (781) 674-1189

## Contact information

- **Practice address:** 33 BEDFORD ST, SUITE 20, LEXINGTON, MA 02420-4319
- **Practice address phone:** (781) 674-1189
- **Practice address fax:** (781) 863-2646
- **Mailing address:** 33 BEDFORD ST, SUITE 20, LEXINGTON, MA 02420-4319
- **Mailing address phone:** (781) 674-1189
- **Mailing address fax:** (781) 863-2646

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 118496 | MA | — |
| 101YM0800X | Mental Health Counselor | 6779 | MA | Yes |

## Other

- **Enumeration date:** 09/03/2015
- **Last updated:** 09/03/2015