Emily Rose Gustafson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19227 Issued in MN

Practice address

15243 Nowthen Blvd NW
Ramsey, MN 55303-6138

Phone

(612) 900-0233

Fax

(866) 627-0910

NPI assigned

Jul 8, 2025

Last updated

Jul 8, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Conscious Healing Counseling Inc

  • Mental Health Counselor
  • Andover, MN
  • NPI 1366944597
  Medicare reassignment NPD

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

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1871483248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9774 MAGNOLIA ST NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335431",
            "telephone_number": "763-807-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15243 NOWTHEN BLVD NW",
            "city": "RAMSEY",
            "state": "MN",
            "postal_code": "553036138",
            "telephone_number": "612-900-0233",
            "fax_number": "866-627-0910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2705 Bunker Lake Blvd NW Ste 112",
            "address_purpose": "LOCATION",
            "city": "Andover",
            "state": "MN",
            "postal_code": "553043785",
            "country_code": "US",
            "telephone_number": "612-900-0233",
            "fax_number": "866-627-0910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "EMILY",
        "middle_name": "ROSE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justus Ngwa Fusi, REGISTERED NURSE
• Jennifer Lynne Gaalswyk, REGISTERED NURSE
• Karen Theresa Gallus, PHARM.D.
• Edward George, CNP
• Gifted Home Health Care LLC
• Hands Hooves and Hearts Therapeutic Services LLC
• Hanid Healthcare LLC
• Melissa L Hansen, MD
• Harmony Nest Home Care
• Healing Therapeutic Services, LLC

• Clinical Social Worker in Ramsey, MN
• Providers in Ramsey, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.