Felicia Marie Gustafson, BEHAVIORAL TECH

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

101 W 2ND St
Duluth, MN 55802-2086

Phone

(218) 724-3122

Fax

(833) 933-0639

NPI assigned

Aug 23, 2023

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Accend Services Incorporated

  • Adult Mental Health Clinic/Center
  • Duluth, MN
  • NPI 1417023458
  NPD (past)

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1962286567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022086",
            "telephone_number": "218-724-3122",
            "fax_number": "833-933-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022086",
            "telephone_number": "218-724-3122",
            "fax_number": "833-933-0639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 7th St",
            "address_purpose": "LOCATION",
            "city": "Two Harbors",
            "state": "MN",
            "postal_code": "556161528",
            "country_code": "US",
            "telephone_number": "218-834-6005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "FELICIA",
        "middle_name": "MARIE",
        "credential": "BEHAVIORAL TECH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rami Guirguis, DDS, MS
• Susan Guirguis, DDS
• Benita Gusaas-Goodwin, MSW, LICSW
• Bonnie M Gustafson, APRN, CNP
• Emily Gustafson, DNP-FNP
• Rebel K Gustafson, MSW, LICSW
• Emily Gutfleisch
• Camryn Haak
• Isabelle Haakonson
• Tara Haakonson, PHARMD

• Behavior Technician in Duluth, MN
• Providers in Duluth, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.