NPIMap

Organization Active NPI

Connect Online Counseling LLC

  • Clinical Social Worker
  • Warrenville, IL
National Provider Identifier
1679188148
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CONNECT ONLINE COUNSELING LLC
Practice address
4320 Winfield Rd Ste 200
Warrenville, IL 60555-4023
Phone
(630) 410-9587
NPI assigned
Sep 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Authorized official

Name
Kimberley Milton, LCSW, CADCNPI 1316447501
Title
Manager
Phone
(630) 410-9550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4320 Winfield Rd Ste 200
Warrenville, IL 60555-4023

Mailing address

1772 Melbourne LN
Aurora, IL 60503-7601
Phone (630) 410-9550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201218000232 IL Part B Supplier - Clinic/Group Practice 6507278421 Receives reassigned benefits from 8 practitioners
Practice locations: Warrenville, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703203200000",
    "number": "1679188148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1772 MELBOURNE LN",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605037601",
            "telephone_number": "630-410-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 WINFIELD RD STE 200",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605554023",
            "telephone_number": "630-410-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECT ONLINE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-11",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-21",
        "status": "A",
        "authorized_official_last_name": "MILTON",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "630-410-9550",
        "authorized_official_credential": "LCSW, CADC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.