The Connected Self, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

THE CONNECTED SELF, LLC

Doing business as

The Connected Self

Practice address

595 Dorset St Ste 7
South Burlington, VT 05403-6240

Phone

(978) 852-9093

NPI assigned

Feb 2, 2023

Last updated

Feb 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristin Quill, MSW, LICSWNPI 1568192094

Title

Owner/Psychotherapist

Phone

(978) 852-9093

Specialties & licenses 1

Addresses

Other names 1

• The Connected Self Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristin Quill, LICSW

  • Clinical Social Worker
  • Burlington, VT
  • NPI 1568192094
  NPD Authorized official

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1760188627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 DORSET ST STE 7",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036240",
            "telephone_number": "978-852-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 DORSET ST STE 7",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036240",
            "telephone_number": "978-852-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CONNECTED SELF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "QUILL",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "978-852-9093",
        "authorized_official_credential": "MSW, LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Connected Self",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Connected Self",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Noelle C Thabault, M.D.
• Paulette J Thabault, ANP
• Susanna Bradley Thach, M.D.
• The Adams Center for Mind & Body LLC
• The Adams Center for Mind and Body, LLC
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• The Medical Store, LTD.
• Theodorou Dental Partners LLC
• Amy Thibault, M.D.
• Tania Thomas, CNM

• Clinical Social Worker in South Burlington, VT
• Providers in South 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 Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.