Wayne Eric Gustafson, D.MIN.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LMHC 002006 Issued in NY

Practice address

224 Forest Home Dr
Ithaca, NY 14850-2747

Phone

(607) 857-0003

NPI assigned

Apr 29, 2015

Sex

Male

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": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1851778757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 RACHEL CARSON WAY",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148508402",
            "telephone_number": "607-857-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 FOREST HOME DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148502747",
            "telephone_number": "607-857-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "WAYNE",
        "middle_name": "ERIC",
        "credential": "D.MIN.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "LMHC 002006",
            "primary": true
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Gumaer, LCSW
• Estela Gumina, FNP-C
• Jennifer Hill Gunn, MD
• Loveena Gupta, DDS
• Sushilkumar Satish Gupta, MD
• Theresa Gustaveson, LMSW
• Guthrie Clinic LTD
• Guthrie Clinic LTD.
• Guthrie Medical Group PC
• Guthrie Medical Group, P.C.

• Mental Health Counselor in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.