Tanya Lane Gustafson, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2002301 Issued in OH

Practice address

356 Brittany LN
Elyria, OH 44035-4169

Phone

(615) 294-1376

NPI assigned

May 9, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1778284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778284800000",
    "number": "1073441234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 BRITTANY LN",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440354169",
            "telephone_number": "615-294-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 BRITTANY LN",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440354169",
            "telephone_number": "615-294-1376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "TANYA",
        "middle_name": "LANE",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-09",
        "last_updated": "2026-05-09",
        "certification_date": "2026-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801108663",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2002301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guidestone
• Kristin W Guilonard, DO
• Matthew Paul Gump-Massey
• Usha Gupta, M.D.
• Chasidy Lee Gurley, I.P
• Andrew Cole Haefele, PA-C
• Elizabeth Signor Hall, LPN
• Roy Hall
• Sonya Maria Hall, LPN
• Dana Leigh Hallman, RN BSN

• Clinical Social Worker in Elyria, OH
• Providers in Elyria, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.