Active NPI
Eileen Gustafson LCSW PA
- Community/Behavioral Health Agency
- Tampa, FL
National Provider Identifier
1396933446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- LCSW 6283
- Legal business name
- EILEEN GUSTAFSON LCSW PA
- Practice address
- 10335 Cross Creek Blvd
Suite 23
Tampa, FL 33647-2795 - Phone
- (352) 428-8463
- Fax
- (352) 597-2074
- NPI assigned
- Oct 12, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Eileen Gustafson, LCSW
- Title
- Owner/Therapist
- Phone
- (352) 428-8463
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | LCSW 6283 | FL | Primary |
Addresses
Primary practice location
10335 Cross Creek Blvd
Suite 23
Tampa, FL 33647-2795
Mailing address
PO Box 5797
Spring Hill, FL 34611-5797
Phone (352) 428-8463
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Tampa, FL
- NPI 1477545846
-
- Professional Counselor
- Tampa, FL
- NPI 1457438384
-
- Mental Health Counselor
- Tampa, FL
- NPI 1821084989
-
- Mental Health Counselor
- Tampa, FL
- NPI 1154323798
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192147200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1218499200000",
"number": "1396933446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5797",
"city": "SPRING HILL",
"state": "FL",
"postal_code": "346115797",
"telephone_number": "352-428-8463",
"fax_number": "352-597-2074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10335 CROSS CREEK BLVD",
"address_2": "SUITE 23",
"city": "TAMPA",
"state": "FL",
"postal_code": "336472795",
"telephone_number": "352-428-8463",
"fax_number": "352-597-2074"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EILEEN GUSTAFSON LCSW PA",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-12",
"last_updated": "2008-08-12",
"status": "A",
"authorized_official_last_name": "GUSTAFSON",
"authorized_official_first_name": "EILEEN",
"authorized_official_title_or_position": "OWNER/THERAPIST",
"authorized_official_telephone_number": "352-428-8463",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "FL",
"license": "LCSW 6283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.