Vermont Wellness Collaborative LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

VERMONT WELLNESS COLLABORATIVE LLC

Practice address

8 Pearl St
Essex Junction, VT 05452-3604

Phone

(802) 497-4864

NPI assigned

Jun 18, 2019

Organization subpart

No

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

Authorized official

Name

Cyrus Patten, LICSW

Title

Director

Phone

(802) 497-4864

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560816000000",
    "number": "1972163343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 PEARL ST",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054523604",
            "telephone_number": "802-497-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 PEARL ST",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054523604",
            "telephone_number": "802-497-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERMONT WELLNESS COLLABORATIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A",
        "authorized_official_last_name": "PATTEN",
        "authorized_official_first_name": "CYRUS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "802-497-4864",
        "authorized_official_credential": "LICSW"
    },
    "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": "1025959",
            "state": "VT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.vermontwellness.org",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "8 Pearl St",
            "city": "Essex Junction",
            "state": "VT",
            "country_code": "US",
            "postal_code": "054523604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Essex Junction, VT
• Providers in Essex Junction, 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 Jun 18, 2019; 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.