Ray H Gustavson, M.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904003881 Issued in VA

Practice address

2296 Opitz Blvd Ste 270
50 South Pickett St, Suite 224, Alexandria, VA. 22304
Woodbridge, VA 22191-3345

Phone

(703) 580-5600

NPI assigned

Oct 18, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1710068788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15647 MONTVIEW DR",
            "city": "MONTCLAIR",
            "state": "VA",
            "postal_code": "220251327",
            "telephone_number": "703-580-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2296 OPITZ BLVD STE 270",
            "address_2": "50 SOUTH PICKETT ST, SUITE 224, ALEXANDRIA, VA. 22304",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913345",
            "telephone_number": "703-580-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAVSON",
        "first_name": "RAY",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904003881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8919615",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Milad Gulalam
• Krishan Kumar Gulati, M.D
• Nida Gulfam, D.O.
• Asheesh Gupta, M.D., M.P.H.
• Paroni Gupta, NP-C
• Alejandra Gutierrez, OTR/L
• Dina Guzman Martinez, RBT
• Georgina Gyamfi
• Dora O Gyasi, FNP-BC
• H Oskuiyan MD PC

• Clinical Social Worker in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.