Vermont Wellness Collaborative Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

VERMONT WELLNESS COLLABORATIVE INC

Practice address

125 Saint Paul St Ste 108
Burlington, VT 05401-8686

Phone

(802) 316-8288

NPI assigned

Dec 7, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cyrus PattenNPI 1871962332

Title

Director

Phone

(802) 316-8288

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cyrus Patten, LICSW

  • Clinical Social Worker
  • Burlington, VT
  • NPI 1871962332
  Medicare reassignment NPD Authorized official
• Diana Keenan, LICSW

  • Clinical Social Worker
  • Burlington, VT
  • NPI 1376167528
  Medicare reassignment NPD
• Melissa Gaudio, LICSW

  • Clinical Social Worker
  • Burlington, VT
  • NPI 1366050494
  NPD (past)
• Sarah Kulig, LCMHC

  • Mental Health Counselor
  • Canaan, NH
  • NPI 1528428455
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1134830409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SAINT PAUL ST STE 108",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SAINT PAUL ST STE 108",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018686",
            "telephone_number": "802-316-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERMONT WELLNESS COLLABORATIVE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "PATTEN",
        "authorized_official_first_name": "CYRUS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "802-316-8288"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6701726",
            "state": "VT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.vermontwellness.org",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "125 Saint Paul St Ste 108",
            "city": "Burlington",
            "state": "VT",
            "country_code": "US",
            "postal_code": "054018686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vermont Natural Family Medicine, PLC
• Vermont Neuropsychology LLC
• Vermont Pain Relief, LLC
• Vermont Psychiatry, LLC
• Vermont Psychological Services: Leitenberg Center for Evidence-Based P
• Christina Vetter Raisanen, BCBA
• Bruce A. Viani, M.D.
• Colleen Victor, MD
• Lorren J Vidana, LCMHC
• Julie T Vieth, MD

• Clinical Social Worker in Burlington, VT
• Providers in Burlington, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.