WAYNE ERIC GUSTAFSON (NPI# 1851778757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851778757 |
| Entity Type | Individual |
| Full Name | WAYNE ERIC GUSTAFSON |
| Credential | D.MIN. |
| Practice Address |
224 Forest Home Dr Ithaca NY 14850-2747 |
| Mailing Address |
201 Rachel Carson Way Ithaca NY 14850-8402 |
| Practice Telephone | 6078570003 |
| Mailing Telephone | 6078570003 |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2015-04-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LMHC 002006 | NY | Behavioral Health & Social Service Providers |
| N | 101YP1600X |
Counselor Specialization: Pastoral |
Behavioral Health & Social Service Providers |
| Street Address |
224 FOREST HOME DR |
| City | ITHACA |
| State | NY |
| Zip Code | 14850-2747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174123897 | Michelle Lee Sanito | Registered Nurse | 400 Lake Street, Ithaca, NY 14850 | 2020-10-30 |
| 1457959843 | Summit Alternatives Lmsw PC | Community/Behavioral Health | 215 North Cayuga Street, 2nd Floor Business Complex, Ithaca, NY 14850 | 2020-10-16 |
| 1518581701 | Sameer Acharya | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency, Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850 | 2020-06-03 |
| 1699399873 | Anurag Aryal | Student in an Organized Health Care Education/Training Program | 101 Dates Drive Internal Medicine Residency, Cayuga Med, Ithaca, NY 14850 | 2020-06-03 |
| 1932723228 | Binay Kumar Kshetree | Student in an Organized Health Care Education/Training Program | Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850 | 2020-06-02 |
| 1225657349 | Nima Hazrati Pour Fard | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Cayuga Medical Center, 101, Ithaca, NY 14850 | 2020-04-09 |
| 1326671090 | Garret Hoskey | Specialist/Technologist | 953 Dany Road, Ithaca, NY 14850 | 2020-02-20 |
| 1609407709 | En-ting Hsu | Marriage & Family Therapist | 110 N. Cayuga Street 4th Floor Suite 3, Ithaca, NY 14850 | 2020-01-28 |
| 1306491063 | Patrick Owen Mckeon | Specialist/Technologist | Hill Center G66, 953 South Danby Rd., Ithaca, NY 14850 | 2019-08-08 |
| 1538722343 | Priyesh Thakurathi | Student in an Organized Health Care Education/Training Program | 101 Dates Drive Cayuga Medical Center, Internal Medicine Residency Program, Ithaca, NY 14850 | 2019-04-17 |
| Find all providers in zip 14850 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366062234 | Elizabeth Anne Mellin | Counselor | 1168 Ellis Hollow Rd, Ithaca, NY 14850-2946 | 2020-04-21 |
| 1871042416 | Adam James Scholl | Counselor | 166 Van Dorn Rd S, Ithaca, NY 14850-9275 | 2016-09-23 |
| 1164809034 | Amanda Nicole Bashi | Counselor | 136 Westhaven Rd, Ithaca, NY 14850-3026 | 2015-04-29 |
| 1326431834 | Jayda E Calhoun | Counselor | 903 Hanshaw Rd Ste 7, Ithaca, NY 14850-1530 | 2015-03-08 |
| 1194127886 | Cheryl Delaney | Counselor | 100 Rachel Carson Way, Ithaca, NY 14850-9395 | 2014-09-24 |
| 1871889402 | Daniel A. Cooper | Counselor | 405 Taughannock Blvd, Ithaca, NY 14850-3232 | 2011-06-22 |
| 1275830952 | Daniel Edward Matusiewicz | Counselor | 201 Dey St, Suite 210, Ithaca, NY 14850-3571 | 2011-02-16 |
| 1467762393 | Michael Flint Ellis | Counselor | 230 Rachel Carson Way, Ithaca, NY 14850-8401 | 2010-10-13 |
| 1952635997 | Maria Manna | Counselor | 200 Pleasant Grove Rd Ste 4, Ithaca, NY 14850-2664 | 2009-09-23 |
| 1346483344 | David Beardslee Schwartz | Counselor | 1212 Trumansburg Rd, Ithaca, NY 14850-1314 | 2009-04-07 |
| Find all providers in ITHACA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.