TRACY ELAINE GUSTAFSON MA - NPI 1093230369 - Counselor in Pawtucket, RI

Q: What is Tracy Gustafson's NPI number?

The NPI number for Tracy Gustafson is 1093230369. It was assigned to this individual provider in the NPPES registry on August 8, 2017.

Q: What is Tracy Gustafson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Tracy Gustafson was last updated on August 8, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Tracy Elaine Gustafson Ma NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRACY ELAINE GUSTAFSON MA (NPI 1093230369) is an individual mental health provider in Pawtucket, Rhode Island and active in the NPI registry since August 2017.

NPPES Registry Identity

NPI1093230369

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameTRACY ELAINE GUSTAFSONCredential: MA

Location Address160 BEECHWOOD AVEPawtucket, RI 02860-5402

Mailing Address249 Roosevelt AvePawtucket, RI 02860-2134 · (401) 724-8400 · Fax (401) 724-8488

Phone(401) 724-8400

Fax(401) 724-8488

Sole ProprietorYes

Enumeration DateAugust 8, 2017

✔ NPI 1093230369 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

160 BEECHWOOD AVE, Pawtucket, RI 02860

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN WALKER M.A.

Counselor (Mental Health)