Autumn L Gusdal, BIS

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6071849 Issued in ID

Practice address

210 E 14TH Ave
Post Falls, ID 83854-7659

Phone

(208) 704-0717

NPI assigned

Sep 13, 2019

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1629628409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E 14TH AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838547659",
            "telephone_number": "208-704-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E 14TH AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838547659",
            "telephone_number": "208-704-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSDAL",
        "first_name": "AUTUMN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "BIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "6071849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy E Greene, LMT
• Jason Robert Griffin, MT
• Jacqueline L Groat, PHARM.D
• Grothman, Inc
• Jesse Gurr
• Ann M Hagenbarth
• Emily S Hager, MS, NTP, RWS
• Scott Michael Hager, DDS
• Derrick Lee Hagler
• Joanne Halbrecht, MD

• Social Worker in Post Falls, ID
• Providers in Post Falls, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.