Active NPI
Robert J Narucki, M.A., CP
- Clinical Psychologist
- Colchester, VT
National Provider Identifier
1295807147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 047-0000738
- Practice address
- 899 Main St
Suite One
Colchester, VT 05446-4420 - Phone
- (802) 872-7645
- Fax
- (802) 872-2795
- NPI assigned
- Nov 15, 2006
- Last updated
- Aug 18, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 047-0000738 | VT | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 047-0000738 | VT |
Addresses
Primary practice location
899 Main St
Suite One
Colchester, VT 05446-4420
Mailing address
899 Main St
Suite One
Colchester, VT 05446-4420
Phone (802) 872-7645
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2115240 | Other | VT | FIRST HEALTH |
| 2115240 | Other | COVENTRY | |
| 000466088 | Other | VT | UNITED BEHAVIORAL HEALTH |
| 3009290 | Other | MVP | |
| 200229625 | Other | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN | |
| 1018501 | Medicaid | VT | |
| 9543568 | Other | AETNA | |
| 1295807147 | Other | VT | BLUE CROSS BLUE SHIELD |
| 1295807147 | Other | VT | BCBS |
| 200229625 | Other | CDPHP | |
| 2599445 | Other | VT | CIGNA |
| 3009290 | Other | VT | MVP |
| 644443 | Other | VALUEOPTIONS | |
| 644443 | Other | VALUEOPTIONS MILITARY ONESOURCE | |
| 9543568 | Other | VT | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503014400000",
"number": "1295807147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "899 MAIN ST",
"address_2": "SUITE ONE",
"city": "COLCHESTER",
"state": "VT",
"postal_code": "054464420",
"telephone_number": "802-872-7645",
"fax_number": "802-872-2795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "899 MAIN ST",
"address_2": "SUITE ONE",
"city": "COLCHESTER",
"state": "VT",
"postal_code": "054464420",
"telephone_number": "802-872-7645",
"fax_number": "802-872-2795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NARUCKI",
"first_name": "ROBERT",
"middle_name": "J",
"credential": "M.A., CP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2017-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VT",
"license": "047-0000738",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "VT",
"license": "047-0000738",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "2115240",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "2115240",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "000466088",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "3009290",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN",
"identifier": "200229625",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1018501",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9543568",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1295807147",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1295807147",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "200229625",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2599445",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "3009290",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUEOPTIONS",
"identifier": "644443",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUEOPTIONS MILITARY ONESOURCE",
"identifier": "644443",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9543568",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colchester, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.