Tanja K Gustafson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW021235 Issued in PA

Practice address

11 Robinson St
Pottstown, PA 19464-6421

Phone

(484) 941-0500

NPI assigned

Jul 17, 2017

Last updated

Jun 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

87.07

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Creative Health Services Inc

  • Psychiatry Physician
  • Boyertown, PA
  • NPI 1508933656
  NPD
• Creative Health Services, Inc.

  • Child & Adolescent Psychiatry Physician
  • Pottstown, PA
  • NPI 1124194121
  NPD

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1700309283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 DOWLIN FORGE RD",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193411552",
            "telephone_number": "610-909-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ROBINSON ST",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194646421",
            "telephone_number": "484-941-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "TANJA",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW135393",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW021235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James T Guille, M.D.
• Jennifer Guldin
• Stephanie Linn Guldin
• Naynthra Guru
• Judy Kay Gustafson, LCSW, CAC
• Meredith Haflin
• Kelly Marie Hagenbaugh, LSW
• Collette Hain
• Christine A Haines
• Darryl Ward Hajduczek, D.C.

• Clinical Social Worker in Pottstown, PA
• Providers in Pottstown, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.