Provider Demographics
NPI:1629008842
Name:GURNEY, LORI P (MS)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:P
Last Name:GURNEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CHESTER RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-9459
Mailing Address - Country:US
Mailing Address - Phone:802-885-3449
Mailing Address - Fax:802-885-3449
Practice Address - Street 1:500 CHESTER RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-9459
Practice Address - Country:US
Practice Address - Phone:802-885-3449
Practice Address - Fax:802-885-3449
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0470000704103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1008457Medicaid
VT1008457Medicaid