Healthcare Provider Details

I. General information

NPI: 1629443890
Provider Name (Legal Business Name): NICOLAS ALEXANDRE GURLEY LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2015
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 MOUNTAIN DR
PITTSFIELD MA
01201-7424
US

IV. Provider business mailing address

139 MOUNTAIN DR
PITTSFIELD MA
01201-7424
US

V. Phone/Fax

Practice location:
  • Phone: 212-966-9537
  • Fax: 212-584-5450
Mailing address:
  • Phone: 917-678-7808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number007502
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: