Individual provider Active NPI

Martin Gutride, PHD

  • Mental Health Counselor
  • Reno, NV
National Provider Identifier
1457387763
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PY0085 Issued in NV
Practice address
1699 S Virginia St
Suite 203
Reno, NV 89502-2820
Phone
(775) 323-1200
Fax
(775) 323-2911
NPI assigned
Jun 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PY0085 NV Primary

Addresses

Primary practice location

1699 S Virginia St
Suite 203
Reno, NV 89502-2820

Mailing address

PO Box 7057
Reno, NV 89510-7057
Phone (775) 323-1200

Other identifiers 1

IdentifierTypeStateIssuer
002616013MedicaidNV

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY0085NVMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1457387763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7057",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895107057",
            "telephone_number": "775-323-1200",
            "fax_number": "775-323-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 S VIRGINIA ST",
            "address_2": "SUITE 203",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022820",
            "telephone_number": "775-323-1200",
            "fax_number": "775-323-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTRIDE",
        "first_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "PY0085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002616013",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; 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.