| Michael D. Gusack, Ma, Lmhc | |
|
124 E Miracle Strip Pkwy Ste 602 Mary Esther FL 32569-1991 | |
| (850) 243-7035 | |
| (850) 243-8529 |
| Full Name | Michael D. Gusack, Ma, Lmhc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 124 E Miracle Strip Pkwy Ste 602, Mary Esther, Florida |
| Authorized Official Name and Position | Maria Tumaneng (ASSISTANT MANAGER/BILLING) |
| Authorized Official Contact | 8503848648 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael D. Gusack, Ma, Lmhc Po Box 879 Fort Walton Beach FL 32549-0879 Ph: (850) 243-7035 | Michael D. Gusack, Ma, Lmhc 124 E Miracle Strip Pkwy Ste 602 Mary Esther FL 32569-1991 Ph: (850) 243-7035 |
| NPI Number | 1770048555 |
|---|---|
| Provider Enumeration Date | 02/05/2019 |
| Last Update Date | 02/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770048555 | NPI | - | NPPES |
| NPI | Other | FL | 1548285154 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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