Individual
MR. CHARLES RICHARD GURNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW, LADC
Contact information
Practice address
31 MAIN ST, SUITE 6, BURLINGTON, VT 05401-8407
(802) 379-4286
Mailing address
PO BOX 93, ISLE LA MOTTE, VT 05463-0093
(802) 379-4286
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000094
VT
101YM0800X
Mental Health Counselor
Primary
089-0000306
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093706
VALUE OPTIONS PIN
VT
05
—
1100004
—
VT
01
—
19092
VT BCBS PIN NUMBER
VT
01
—
2029811
CIGNA PIN NUMBER
VT
01
—
217818
MHN PIN NUMBER
VT
01
—
45605
MBC VT PIN NUMBER
VT
01
—
61167
MVP PIN NUMBER
VT
01
—
933840
MAGELLAN PIN NUMBER
VT
05
—
OVN0754
—
VT
Enumeration date
12/02/2006
Last updated
09/17/2013
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