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ACTUALIZE COUNSELING & NUTRITION LLC
NPI 1316571136
Social Worker - Clinical in Arlington, MA

Active since March 02, 2020
30 STANDISH RD, ARLINGTON, MA 02476(781) 430-9833 Get Directions Write a Review

NPPES record last updated: September 25, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Actualize Counseling & Nutrition Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ACTUALIZE COUNSELING & NUTRITION LLC (NPI 1316571136) is a healthcare organization registered as a clinical in Arlington, Massachusetts and active in the NPI registry since March 2020. The organization lists Lisa Keovongsa, Owner, as its authorized official.

NPPES Registry Identity

NPI1316571136
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameACTUALIZE COUNSELING & NUTRITION LLC
Location Address30 STANDISH RDArlington, MA 02476-7069
Mailing Address30 Standish RdArlington, MA 02476-7069 · (781) 430-9833
Phone(781) 430-9833
Organization SubpartNo
Authorized OfficialLisa KeovongsaOwner · (781) 430-9833
Enumeration DateMarch 2, 2020
Last NPPES UpdateSeptember 25, 2023
NPPES CertifiedSeptember 25, 2023
✔ NPI 1316571136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedDietitian, Registered · Nutrition, Obesity and Weight ManagementTaxonomy 133VN1201X
30 STANDISH RD, Arlington, MA 02476
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Actualize Counseling & Nutrition Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Actualize Counseling & Nutrition LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Khamphady Keovongsa, LICSW
Clinical Social Worker
NPI 1194125625
30 STANDISH RD
Arlington, MA 02476
(781) 999-4975
✔ PECOS✔ Accepts MedicareSame address
Lisa Keovongsa, RD, LDN
Registered Dietitian or Nutrition Professional
NPI 1750859286
30 STANDISH RD
Arlington, MA 02476
(781) 430-9833
Same address
Vanessa Beauregard
Registered Dietitian or Nutrition Professional
NPI 1396573135
30 STANDISH RD
Arlington, MA 02476
(781) 999-4975
Same address
Alexis Barnes, LMHC
Mental Health Counselor
NPI 1639793417
175 CRESCENT AVE
Chelsea, MA 02150
(617) 889-8779
✔ PECOS8.9 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Actualize Counseling & Nutrition LLC's NPI number?

The NPI number for Actualize Counseling & Nutrition LLC is 1316571136. It was assigned to this organization in the NPPES registry on March 2, 2020.

Where is Actualize Counseling & Nutrition LLC located?

Actualize Counseling & Nutrition LLC is located at 30 Standish Rd, Arlington, MA 02476. The listed phone number is (781) 430-9833.

What is Actualize Counseling & Nutrition LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Actualize Counseling & Nutrition LLC enrolled in Medicare?

Yes. Actualize Counseling & Nutrition LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Actualize Counseling & Nutrition LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Actualize Counseling & Nutrition LLC, in Clinical Social Worker, Mental Health Counselor and Registered Dietitian or Nutrition Professional. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Actualize Counseling & Nutrition LLC was last updated on September 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.