Individual provider Active NPI

Gwendolyn Ruth Dussan

  • Professional Counselor
  • Manchaca, TX
National Provider Identifier
1386435634
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
90986 Issued in TX
Practice address
780 W FM 1626 Unit 463
Manchaca, TX 78652-2519
Phone
(512) 956-6913
NPI assigned
May 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 90986 TX Primary

Addresses

Primary practice location

780 W FM 1626 Unit 463
Manchaca, TX 78652-2519

Mailing address

780 W FM 1626 Unit 463
Manchaca, TX 78652-2519

Other practice location 1

505 E Huntland Dr Ste 320
Austin, TX 78752-3741
Phone (512) 201-4501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
90986TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1386435634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 W FM 1626 UNIT 463",
            "city": "MANCHACA",
            "state": "TX",
            "postal_code": "786522519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 W FM 1626 UNIT 463",
            "city": "MANCHACA",
            "state": "TX",
            "postal_code": "786522519",
            "telephone_number": "512-956-6913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 E Huntland Dr Ste 320",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787523741",
            "country_code": "US",
            "telephone_number": "512-201-4501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUSSAN",
        "first_name": "GWENDOLYN",
        "middle_name": "RUTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-15",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "90986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchaca, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; 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.