Charles Richard Gurney, LICSW, LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

089-0000306 Issued in VT

Practice address

31 Main St
Suite 6
Burlington, VT 05401-8407

Phone

(802) 379-4286

NPI assigned

Dec 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Matrix Health Systems P.C.

  • Clinical Psychologist
  • Burlington, VT
  • NPI 1104872712
  NPD (past)

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1093883365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93",
            "city": "ISLE LA MOTTE",
            "state": "VT",
            "postal_code": "054630093",
            "telephone_number": "802-379-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 MAIN ST",
            "address_2": "SUITE 6",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018407",
            "telephone_number": "802-379-4286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURNEY",
        "first_name": "CHARLES",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "LICSW, LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-02",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "089-0000306",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "000094",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN0754",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VT BCBS PIN NUMBER",
            "identifier": "19092",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN NUMBER",
            "identifier": "2029811",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PIN NUMBER",
            "identifier": "933840",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN PIN NUMBER",
            "identifier": "217818",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1100004",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBC VT PIN NUMBER",
            "identifier": "45605",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PIN",
            "identifier": "093706",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP PIN NUMBER",
            "identifier": "61167",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sigfus Kristinn Gunnlaugsson
• Ena Gupta, M.D
• Nishtha Gupta, MD
• Tanush Gupta, M.D.
• Dore E Guptil
• Sarah Ellen Eberhardt Guth, MD
• Ian Guthrie
• Jose Manuel Gutierrez Amezcua, MD
• Alan Gwertzman, MD
• Jennifer Ha

• Mental Health Counselor in Burlington, VT
• Providers in Burlington, VT by specialty
• Mental Health Counselor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.