Individual provider Active NPI

Matthew G Durney

  • Professional Counselor
  • Erie, PA
National Provider Identifier
1477018422
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC009862 Issued in PA
Practice address
3910 Caughey Rd
Erie, PA 16506-4096
Phone
(814) 920-4786
NPI assigned
Feb 4, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC009862 PA Primary

Addresses

Primary practice location

3910 Caughey Rd
Erie, PA 16506-4096

Mailing address

947 W 25TH St
Erie, PA 16502-2426
Phone (814) 671-0205

Other practice location 1

4320 Dexter Ave
Erie, PA 16504-2444
Phone (814) 825-2930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 5, 2024 through Feb 5, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PC009862PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Abcs of Building Better Lives LLC Professional PastSince Sep 1, 2012 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1477018422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 W 25TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022426",
            "telephone_number": "814-671-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 CAUGHEY RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064096",
            "telephone_number": "814-920-4786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4320 Dexter Ave",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165042444",
            "country_code": "US",
            "telephone_number": "814-825-2930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURNEY",
        "first_name": "MATTHEW",
        "middle_name": "G",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-04",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC009862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.