Individual provider Active NPI

Nanna Gustin, LPC

  • Mental Health Counselor
  • Amarillo, TX
National Provider Identifier
1033867734
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
61153 Issued in TX
Practice address
6319 Oakcrest LN
Amarillo, TX 79109-6990
Phone
(806) 681-5025
NPI assigned
Mar 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 61153 TX
Mental Health Counselor 101YM0800X 61153 TX Primary

Addresses

Primary practice location

6319 Oakcrest LN
Amarillo, TX 79109-6990

Mailing address

6319 Oakcrest LN
Amarillo, TX 79109-6990
Phone (806) 681-5025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240817000451 TX Practitioner - Mental Health Counselor 7012455397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brave Health Medical Group, PAGroup PAC ID 9537586052, 93 clinicians

Practice addresses (Care Compare)

6319 Oakcrest LN
Amarillo, TX 79109-6990
Phone (305) 902-6347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61153TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Health Medical Group PA Mental Health CurrentSince Sep 1, 2024 Accepting new patients

Locations

1951 NW 7th Ave
Fl 3
Miami, FL 33136
Phone (305) 297-4749

675 Town Square Blvd
Ste 200
Garland, TX 75040
Phone (305) 579-9538

Interoperability endpoints

  • Direct secure messaging: nanna.gustin.1@23300.direct.athenahealth.com

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": "1647129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1033867734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6319 OAKCREST LN",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791096990",
            "telephone_number": "806-681-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6319 OAKCREST LN",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791096990",
            "telephone_number": "806-681-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTIN",
        "first_name": "NANNA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-13",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "61153",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "61153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.