Active NPI
Richard L. Gustafson, LPC
- Professional Counselor
- Anchorage, AK
National Provider Identifier
1902198872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 527
- Practice address
- 4320 Diplomacy Dr
Suite 1500
Anchorage, AK 99508-5925 - Phone
- (907) 729-2500
- NPI assigned
- May 10, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 527 | AK | Primary |
Addresses
Primary practice location
4320 Diplomacy Dr
Suite 1500
Anchorage, AK 99508-5925
Mailing address
4501 Diplomacy Dr
Attn: Provider Enrollment Services
Anchorage, AK 99508-5919
Phone (907) 729-8624
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 527 | AK | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southcentral Foundation | Past | Accepting new patients | |
| Southcentral Foundation | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Anchorage, AK
- NPI 1124064894
-
- Community/Behavioral Health Agency
- Anchorage, AK
- NPI 1306499710
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374451200000",
"number": "1902198872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4501 DIPLOMACY DR",
"address_2": "ATTN: PROVIDER ENROLLMENT SERVICES",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085919",
"telephone_number": "907-729-8624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4320 DIPLOMACY DR",
"address_2": "SUITE 1500",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085925",
"telephone_number": "907-729-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSTAFSON",
"first_name": "RICHARD",
"middle_name": "L.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-10",
"last_updated": "2013-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AK",
"license": "527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.