Erin Marie Gustafson, LCSW

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

6501 S Promontory Dr
Chicago, IL 60649-1003

Phone

(773) 256-5778

NPI assigned

May 2, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Erin Marie James Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Erin Gustafson Consulting PLLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1184352544
  NPD Authorized official

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1942591466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 S PROMONTORY DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606491003",
            "telephone_number": "773-256-5778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 S PROMONTORY DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606491003",
            "telephone_number": "773-256-5778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-02",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017736",
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "JAMES",
            "middle_name": "MARIE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alyssa Nicole Gustafson, SLP-CFY
• Andrew A Gustafson, MD
• Dawn M Gustafson, PT
• Elizabeth Gustafson, OTR/L
• Erika Luz Gustafson, PHD
• Jennifer Lynn Gustafson, RD,LDN,CDE.
• Melissa Gustafson, LSW
• Carl Joseph Gustas Sr., DO
• Kristin A. R. Gustashaw, M.S., R.D., L.D.N.
• Emmanuel Gustave, PHARMD

• Developmental Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Developmental Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.