Rebel K Gustafson, MSW, LICSW | |
407 E 3rd St, Duluth, MN 55805-1950 | |
(218) 786-4000 | |
Not Available |
Full Name | Rebel K Gustafson |
---|---|
Gender | Female |
Speciality | Clinical Social Worker |
Experience | 30 Years |
Location | 407 E 3rd St, Duluth, Minnesota |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1407061047 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 8719 (Minnesota) | Primary |
1041C0700X | Social Worker - Clinical | 8589 (Wisconsin) | Secondary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Innovative Psychological Consultants, Llc | 3678596285 | 13 |
Entity Name | Innovative Psychological Consultants, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942221080 PECOS PAC ID: 3678596285 Enrollment ID: O20060110000633 |
Mailing Address | Practice Location Address |
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Rebel K Gustafson, MSW, LICSW 400 E 3rd St, Credentialing Dept., Mcl2cred, Duluth, MN 55805-1951 Ph: (218) 786-3146 | Rebel K Gustafson, MSW, LICSW 407 E 3rd St, Duluth, MN 55805-1950 Ph: (218) 786-4000 |
Melissa Ann Winkler, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4000 W 9th St, Duluth, MN 55807 Phone: 218-625-2638 Fax: 651-323-2184 | |
Emily Lundgren, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11 E Superior St Ste 415, Duluth, MN 55802 Phone: 218-249-0595 | |
Glenn Howard Tobey, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 17 1/2 N Lake Ave Rm 201, Duluth, MN 55802 Phone: 218-740-4389 Fax: 218-740-4389 | |
Natalie Jo Ryan, MSW, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 810 E 4th St, Duluth, MN 55805 Phone: 218-624-5683 Fax: 218-624-5736 | |
Zayla Asquith-heinz, LGSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4325 Grand Ave, Duluth, MN 55807 Phone: 218-722-1497 Fax: 218-722-6239 | |
Sara A Fijalkiewicz, MSW, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 120 W 2nd St, Duluth, MN 55802 Phone: 218-728-4491 Fax: 218-302-8698 | |
Wendy Michelle Olson, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 400 E 3rd St, Essentia Health Duluth Clinic, Duluth, MN 55805 Phone: 218-786-8364 |