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EILEEN GUSTAFSON LCSW PA
NPI 1396933446
Community/Behavioral Health in Tampa, FL

Active since October 12, 2007
10335 CROSS CREEK BLVD, SUITE 23, TAMPA, FL 33647(352) 428-8463(352) 597-2074 Get Directions Write a Review

NPPES record last updated: August 12, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Eileen Gustafson Lcsw Pa NPPES

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

EILEEN GUSTAFSON LCSW PA (NPI 1396933446) is a healthcare organization registered as a community/behavioral health in Tampa, Florida and active in the NPI registry since October 2007. The organization lists Eileen Gustafson, Owner/therapist, as its authorized official.

NPPES Registry Identity

NPI1396933446
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameEILEEN GUSTAFSON LCSW PA
Location Address10335 CROSS CREEK BLVD, SUITE 23Tampa, FL 33647-2795
Mailing AddressPo Box 5797Spring Hill, FL 34611-5797 · (352) 428-8463 · Fax (352) 597-2074
Phone(352) 428-8463
Fax(352) 597-2074
Organization SubpartNo
Authorized OfficialEileen GustafsonOwner/therapist · (352) 428-8463
Enumeration DateOctober 12, 2007
Last NPPES UpdateAugust 12, 2008
✔ NPI 1396933446 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
License✔ Licensed in FL · LCSW 6283
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
10335 CROSS CREEK BLVD, Tampa, FL 33647
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Other Identifiers 1

Medicare UPINK9677FL

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eileen Gustafson Lcsw Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateFloridaEnrollment IDO20060419000741Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Eileen Gustafson Lcsw PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Eileen Gustafson, LCSW
Clinical Social Worker
NPI 1477545846
10335 CROSS CREEK BLVD SUITE 23
Tampa, FL 33647
(352) 428-8463
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eileen Gustafson Lcsw PA's NPI number?

The NPI number for Eileen Gustafson Lcsw PA is 1396933446. It was assigned to this organization in the NPPES registry on October 12, 2007.

Where is Eileen Gustafson Lcsw PA located?

Eileen Gustafson Lcsw PA is located at 10335 Cross Creek Blvd Suite 23, Tampa, FL 33647. The listed phone number is (352) 428-8463.

What is Eileen Gustafson Lcsw PA's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Is Eileen Gustafson Lcsw PA enrolled in Medicare?

Yes. Eileen Gustafson Lcsw PA is registered in the Medicare PECOS enrollment system.

When is Eileen Gustafson Lcsw PA's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Eileen Gustafson Lcsw PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Eileen Gustafson Lcsw PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Eileen Gustafson Lcsw PA was last updated on August 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.