Dawn Crystal Gudmundsen

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

001033 Issued in NY

Practice address

229 Laurel Rd
East Northport, NY 11731-1118

Phone

(484) 965-9966

Fax

(484) 231-8631

NPI assigned

Aug 19, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dawn Farrell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1053744532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 FREEDOM BUSINESS CTR DR STE 220",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061376",
            "telephone_number": "484-965-9966",
            "fax_number": "484-231-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 LAUREL RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117311118",
            "telephone_number": "484-965-9966",
            "fax_number": "484-231-8631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3075 34th St",
            "address_2": "Apt 1h",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "NY",
            "postal_code": "111035164",
            "country_code": "US",
            "telephone_number": "631-294-2080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUDMUNDSEN",
        "first_name": "DAWN",
        "middle_name": "CRYSTAL",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-19",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "703164131",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "504297111",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "001033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "FARRELL",
            "credential": "ABA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dianna R Gott, LCSW
• Martin I Granoff, MD
• Johanna Grant, M.S. CCC-SLP
• Nicole L Grimaldi, DPT
• Thomas Michael Gruhn
• Abigail Guerrier
• Megan Guilfoyle, OTL, MS
• Kimberly Guillem, MSED
• Kristine Habel
• Mary Kate Hannigan

• Behavior Analyst in East Northport, NY
• Providers in East Northport, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.