# THE CENTER FOR CANCER LIFESTYLE MANAGEMENT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578256574
- **Authorized official:** DR. CINDY D NESS PHD (FOUNDER AND EXECUTIVE DIRECTOR)
- **Authorized official phone:** (917) 450-4625

## Contact information

- **Practice address:** 308 W 97TH ST APT 4, NEW YORK, NY 10025-6123
- **Practice address phone:** (917) 450-4625
- **Mailing address:** 308 W 97TH ST APT 4, NEW YORK, NY 10025-6123
- **Mailing address phone:** (917) 450-4625

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC1900X | Counseling Psychologist | — | NULL | — |
| 103TC1900X | Counseling Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 133N00000X | Nutritionist | — | NULL | — |
| 133N00000X | Nutritionist | — | — | — |
| 133NN1002X | Nutrition Education Nutritionist | — | NULL | — |
| 133NN1002X | Nutrition Education Nutritionist | — | — | — |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 133VN1006X | Metabolic Nutrition Registered Dietitian | — | NULL | — |
| 133VN1006X | Metabolic Nutrition Registered Dietitian | — | — | — |
| 133VN1301X | Oncology Nutrition Registered Dietitian | — | NULL | — |
| 133VN1301X | Oncology Nutrition Registered Dietitian | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/26/2023
- **Last updated:** 05/26/2023