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MS. NICOLE VIENNA GUSTAFSON L.P.C.
NPI 1790916278
Counselor - Professional in Kenosha, WI

Active since August 02, 2009
4109 67TH ST, KENOSHA, WI 53142(262) 652-9830 Get Directions Write a Review

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Ms. Nicole Vienna Gustafson L.p.c. NPPES

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

MS. NICOLE VIENNA GUSTAFSON L.P.C. (NPI 1790916278) is an individual professional provider in Kenosha, Wisconsin, licensed in Wisconsin (4197-125) and active in the NPI registry since August 2009.

NPPES Registry Identity

NPI1790916278
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMS. NICOLE VIENNA GUSTAFSONCredential: L.P.C.
Location Address4109 67TH STKenosha, WI 53142-3836
Mailing Address4601 Lake Meadow DrWind Point, WI 53402-5319 · (414) 899-3177
Phone(262) 652-9830
Sole ProprietorNo
Enumeration DateAugust 2, 2009
Last NPPES UpdateJune 4, 2026
NPPES CertifiedJune 4, 2026
✔ NPI 1790916278 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in WI · 4197-125
4109 67TH ST, Kenosha, WI 53142
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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.

AMY B ANDERSON MSW
Social Worker (Clinical)
4109 67TH ST
KENOSHA, WI 53142
Kenosha County (262) 652-9830
LISA RIOS-OLIVARES MSW
Counselor (Professional)
4109 67TH ST
KENOSHA, WI 53142
Kenosha County (262) 652-9830
JANE POHL MSW
Social Worker (Clinical)
4109 67TH ST
KENOSHA, WI 53142
Kenosha County (262) 652-9830
LISA SACHS MSW
Social Worker (Clinical)
4109 67TH ST
KENOSHA, WI 53142
Kenosha County (262) 652-9830
KRISTIN MARCHESE MS
Counselor (Professional)
4109 67TH ST
KENOSHA, WI 53142
Kenosha County (262) 652-9830
MARY HEIN LPC-IT
Counselor (Professional)
4109 67TH ST
KENOSHA, WI 53142
Kenosha County (262) 652-9830
DALE HILSON
Counselor (Mental Health)
4109 67TH ST
KENOSHA, WI 53142
Kenosha County (262) 652-9830
MR. NYLES ANTONY JACKSON MSW, APSW, SAC-IT
Social Worker
4109 67TH ST
KENOSHA, WI 53142
Kenosha County (262) 652-9830

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 Nicole Gustafson's NPI number?

The NPI number for Nicole Gustafson is 1790916278. It was assigned to this individual provider in the NPPES registry on August 2, 2009.

Where is Nicole Gustafson located?

Nicole Gustafson practices at 4109 67th St, Kenosha, WI 53142. The listed phone number is (262) 652-9830.

What is Nicole Gustafson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Nicole Gustafson was last updated on June 4, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.