Michael Dean Gusack, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC.0015851 Issued in CO

Practice address

645 Eldorado Blvd Apt 1213
Broomfield, CO 80021-8835

Phone

(850) 737-0022

NPI assigned

Jul 13, 2006

Last updated

May 27, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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 CO, FL2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  FL, Professional

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1548285158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 ELDORADO BLVD APT 1213",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218835",
            "telephone_number": "850-737-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 ELDORADO BLVD APT 1213",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218835",
            "telephone_number": "850-737-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSACK",
        "first_name": "MICHAEL",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0015851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maija Gulens, M.S., CCC-SLP
• Amber Gulley
• Rhett Gulotta, PT
• Scott Noal Gunderson, O.D.
• Aspen Gupton, CCC-SLP
• Nashalie Gutierrez, RBT
• Martha Ha, D.D.S
• Urjoomund Habeeb, CNIM
• Jack Varga Hadwin, DDS
• Edward M Hagen, OD

• Mental Health Counselor in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.