Eileen Gustafson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6283 Issued in FL

Practice address

10335 Cross Creek Blvd
Suite 23
Tampa, FL 33647-2795

Phone

(352) 428-8463

Fax

(352) 597-2074

NPI assigned

Aug 22, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Clinical Social Worker

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Eileen Gustafson LCSW PA

  • Community/Behavioral Health Agency
  • Tampa, FL
  • NPI 1396933446
  Medicare reassignment NPD Authorized official
• McGinn & Teixeira PA

  • Mental Health Counselor
  • Tampa, FL
  • NPI 1982605309
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1477545846",
    "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": {
        "last_name": "GUSTAFSON",
        "first_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "6283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kul B Gupta, MD
• Shanu Gupta, MD
• Jason Gurewitz
• Gurley Dental Group PL
• Michael A Gust, PHARMD
• Vaiva Gustainyte, DO
• Jeseeka Gustave
• Gustavo Ruiz de Castilla DMD PA
• Jamie Gustin
• Lawrence Michael Gustin, M.D.

• Clinical Social Worker in Tampa, FL
• Providers in Tampa, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.