Active NPI
Michele Quintin Quill, L.C.S.W.
- Clinical Social Worker
- Austin, TX
National Provider Identifier
1861924854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 59783
- Practice address
- 4422 Pack Saddle Pass Ste 203
Austin, TX 78745-1644 - Phone
- (512) 763-7002
- Fax
- (512) 367-5656
- NPI assigned
- Mar 30, 2017
- Last updated
- Oct 24, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 59783 | TX | Primary |
Addresses
Primary practice location
4422 Pack Saddle Pass Ste 203
Austin, TX 78745-1644
Mailing address
168 Edmonson LN
Cedar Creek, TX 78612-3254
Phone (512) 656-8862
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2025 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59783 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698105600000",
"number": "1861924854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "168 EDMONSON LN",
"city": "CEDAR CREEK",
"state": "TX",
"postal_code": "786123254",
"telephone_number": "512-656-8862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4422 PACK SADDLE PASS STE 203",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787451644",
"telephone_number": "512-763-7002",
"fax_number": "512-367-5656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUILL",
"first_name": "MICHELE",
"middle_name": "QUINTIN",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-30",
"last_updated": "2023-10-24",
"certification_date": "2023-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "59783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.