Carolyn Marie Gustin, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

A02011 Issued in MD

Practice address

5801 Allentown Road
Suite 410
Camp Springs, MD 20746

Phone

(301) 238-4788

Fax

(301) 298-5442

NPI assigned

Apr 12, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Carolyn Marie Gustin Former name

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": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669334400000",
    "number": "1720421340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 ALLENTOWN ROAD",
            "address_2": "SUITE 410",
            "city": "CAMP SPRINGS",
            "state": "MD",
            "postal_code": "20746",
            "telephone_number": "301-238-4788",
            "fax_number": "301-298-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 ALLENTOWN ROAD",
            "address_2": "SUITE 410",
            "city": "CAMP SPRINGS",
            "state": "MD",
            "postal_code": "20746",
            "telephone_number": "301-238-4788",
            "fax_number": "301-298-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTIN",
        "first_name": "CAROLYN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-12",
        "last_updated": "2022-11-25",
        "certification_date": "2022-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "DC",
            "license": "100000251",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA 13076",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MD",
            "license": "A02011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "GUSTIN",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapy Assistant in Camp Springs, MD
• Providers in Camp Springs, MD by specialty
• Occupational Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2022; 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.