Michael D. Gusack, Ma, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MICHAEL D. GUSACK, MA, LMHC

Practice address

124 E Miracle Strip Pkwy Ste 602
Mary Esther, FL 32569-1991

Phone

(850) 243-7035

Fax

(850) 243-8529

NPI assigned

Feb 5, 2019

Organization subpart

No

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

Authorized official

Name

Miss Maria Tumaneng

Title

Assistant Manager/Billing

Phone

(850) 384-8648

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549324800000",
    "number": "1770048555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 879",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325490879",
            "telephone_number": "850-243-7035",
            "fax_number": "850-243-8529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E MIRACLE STRIP PKWY STE 602",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691991",
            "telephone_number": "850-243-7035",
            "fax_number": "850-243-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D. GUSACK, MA, LMHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A",
        "authorized_official_last_name": "TUMANENG",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "ASSISTANT MANAGER/BILLING",
        "authorized_official_telephone_number": "850-384-8648",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1548285154",
            "identifier": "NPI",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Mary Esther, FL
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• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.