Provider Demographics
NPI:1144689092
Name:SEEDS FOR SUCCESS NUTRITION COUNSELING LLC
Entity type:Organization
Organization Name:SEEDS FOR SUCCESS NUTRITION COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SENISCALCHI
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:732-742-5513
Mailing Address - Street 1:PO BOX 542
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-0542
Mailing Address - Country:US
Mailing Address - Phone:609-994-0202
Mailing Address - Fax:
Practice Address - Street 1:364 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3187
Practice Address - Country:US
Practice Address - Phone:609-994-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-21
Last Update Date:2016-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ819366133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty