Wayne Eric Gustafson, DMIN | |
224 Forest Home Dr, Ithaca, NY 14850-2747 | |
(607) 857-0003 | |
Not Available |
Full Name | Wayne Eric Gustafson |
---|---|
Gender | Male |
Speciality | Counselor - Mental Health |
Location | 224 Forest Home Dr, Ithaca, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851778757 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | LMHC 002006 (New York) | Primary |
101YP1600X | Counselor - Pastoral | (* (Not Available)) | Secondary |
Mailing Address | Practice Location Address |
---|---|
Wayne Eric Gustafson, DMIN 201 Rachel Carson Way, Ithaca, NY 14850-8402 Ph: (607) 857-0003 | Wayne Eric Gustafson, DMIN 224 Forest Home Dr, Ithaca, NY 14850-2747 Ph: (607) 857-0003 |
Peter Dodge, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 334 W State St, Ithaca, NY 14850 Phone: 607-273-5500 Fax: 607-273-1277 | |
Andrea Arden Gerding, MSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 201 E Green St Fl 5, Ithaca, NY 14850 Phone: 607-274-6288 Fax: 607-274-6280 | |
Mrs. Amy Abbasov, M.ED. LPC-S Counselor Medicare: Not Enrolled in Medicare Practice Location: 23 Besemer Ln, Ithaca, NY 14850 Phone: 806-236-4156 | |
Stacy Cangelosi Mike, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 201 E Green St, Suite 500, Ithaca, NY 14850 Phone: 607-274-6288 | |
Mr. Allen John Agnew, CASAC NYS 13121 Counselor Medicare: Not Enrolled in Medicare Practice Location: 201 E Green St, Suite 500, Ithaca, NY 14850 Phone: 607-274-6288 Fax: 607-274-6280 | |
Vanessa Hendrickson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 201 E Green St Ste 500, Ithaca, NY 14850 Phone: 607-274-6288 Fax: 607-274-6280 | |
Mr. Colin Andrew Polnitsky, MSW INTERN Counselor Medicare: Medicare Enrolled Practice Location: 201 E Green St, Ithaca, NY 14850 Phone: 607-274-6288 Fax: 607-274-6280 |