Healthcare Provider Details

I. General information

NPI: 1043601172
Provider Name (Legal Business Name): TRANSCEND NUTRITION COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 02/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10205 FOUR MILE CREEK RD
CHARLOTTE NC
28277-8701
US

IV. Provider business mailing address

10205 FOUR MILE CREEK RD
CHARLOTTE NC
28277-8701
US

V. Phone/Fax

Practice location:
  • Phone: 704-640-4161
  • Fax:
Mailing address:
  • Phone: 704-640-4161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberL003980
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License NumberL003980
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License NumberL003980
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License NumberL003980
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License NumberL003980
License Number StateNC
# 6
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL003980
License Number StateNC

VIII. Authorized Official

Name: MELANIE MILLER DWYER
Title or Position: MEMBER
Credential: RDN, LDN
Phone: 704-640-4161