CLINICAL WEIGHT LOSS & WELLNESS LLC (NPI# 1265990030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265990030 |
| Entity Type | Organization |
| Organization Name | CLINICAL WEIGHT LOSS & WELLNESS LLC |
| Practice Address |
2790 Main St Glastonbury CT 06033-2027 |
| Practice Telephone | 8604309922 |
| Practice Fax Number | 8606339922 |
| Mailing Telephone | 8604309922 |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2020-10-02 |
| Authorized Official Name | MS. JEANNIE MARIE LEITAO (OWNER/CEO) |
| Authorized Official Telephone | 8604309922 |
| Authorized Official Credential | RD, CDE, CDN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| Street Address |
2790 MAIN ST |
| City | GLASTONBURY |
| State | CT |
| Zip Code | 06033-2027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598094963 | Jeannie Marie Leitao | Nutritionist | 2790 Main St, Glastonbury, CT 06033-2027 | 2009-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477074649 | Starling Physicians, PC | Durable Medical Equipment & Medical Supplies | 289 Western Blvd, Glastonbury, CT 06033 | 2017-06-28 |
| 1497284897 | D&l Eyecare | Optometrist | 33 Welles Street, Glastonbury, CT 06033 | 2017-06-08 |
| 1730626235 | Half Full Psychiatry LLC | Clinic/Center | 39 New London Tpke Ste 230f, Glastonbury, CT 06033 | 2017-01-23 |
| 1285000117 | Olga A Levkina | Physician Assistant | 2928 Main St Ste 101, Glastonbury, CT 06033 | 2015-08-14 |
| 1619350576 | Ryan Ilg Reichelt | Dentist | 131 New London Tpke Ste 211, Glastonbury, CT 06033 | 2015-07-09 |
| 1316320534 | Devon Banda | Orthopaedic Surgery | The Hand Center, 195 Eastern Blvd, # 200, Glastonbury, CT 06033 | 2015-07-07 |
| 1881073195 | Brittney Stanley | Counselor | 122 Naubuc Ave Ste 104, Glastonbury, CT 06033 | 2015-05-20 |
| 1780071878 | Richard T. Risinger | Dentist | 88 Citizens Drive, Glastonbury, CT 06033 | 2015-04-16 |
| 1639568751 | Carol Jane Gammell | Counselor | 140 Glastonbury Boulevard, Suite 30, Glastonbury, CT 06033 | 2015-01-13 |
| 1407262611 | Prashant Sinha | Dentist | 2874 Main Street, Glastonbury, CT 06033 | 2014-07-08 |
| Find all providers in zip 06033 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740750835 | Lisa Shettle | Dietitian, Registered | 65 Kelsey Ln, Glastonbury, CT 06033-5040 | 2018-11-30 |
| 1073982047 | Therese Mcconnell Nuzzolo | Dietitian, Registered | 26 Breeds Hill Rd, Nuzzolo Nutriton, Glastonbury, CT 06033-3733 | 2015-09-21 |
| 1326302340 | Empower Health Solutions LLC | Dietitian, Registered | 9 Grey Rocks Ct, Glastonbury, CT 06033-2626 | 2012-06-25 |
| 1336387406 | Cara C Andreoli | Dietitian, Registered | 99 Citizens Dr, Glastonbury, CT 06033-1262 | 2009-01-28 |
| 1235302316 | Maria R Fill | Dietitian, Registered | 41b New London Tpke, Glastonbury, CT 06033-4240 | 2008-04-09 |
| 1568479780 | Wendy R Kane | Dietitian, Registered | 972 New London Tpke, Glastonbury, CT 06033-3024 | 2006-08-01 |
| 1972074995 | Marisa Butler | Dietitian, Registered | 330 Western Blvd, Glastonbury, CT 06033-4383 | 2018-12-17 |
| 1598138588 | Julie Peterson | Dietitian, Registered | 290 Western Blvd, Glastonbury, CT 06033-1236 | 2015-11-12 |
| 1811251606 | Deborah A Brinckman | Dietitian, Registered | 9 Grey Rocks Ct, Glastonbury, CT 06033-2626 | 2012-06-27 |
| 1134487507 | Nutrition and Wellness Consulting, LLC | Dietitian, Registered | 300 Hebron Ave Ste 107, Glastonbury, CT 06033-2176 | 2012-04-24 |
| Find all providers in GLASTONBURY | ||||
| City | GLASTONBURY |
| Zip Code | 06033 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.