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MS. MARY BETH GUSTAFSON LICSW
NPI 1902138480
Social Worker - Clinical in Minneapolis, MN

Active since February 08, 2010
1845 E LAKE ST, MINNEAPOLIS, MN 55407(612) 721-6215(612) 721-5848 Get Directions Write a Review

NPPES record last updated: February 8, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Mary Beth Gustafson Licsw NPPES

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

MS. MARY BETH GUSTAFSON LICSW (NPI 1902138480) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (15931) and active in the NPI registry since February 2010.

NPPES Registry Identity

NPI1902138480
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMS. MARY BETH GUSTAFSONCredential: LICSW
Location Address1845 E LAKE STMinneapolis, MN 55407-1859
Mailing Address1845 E Lake StMinneapolis, MN 55407-1859 · (612) 721-6215 · Fax (612) 721-5848
Phone(612) 721-6215
Fax(612) 721-5848
Sole ProprietorNo
Enumeration DateFebruary 8, 2010
✔ NPI 1902138480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MN · 15931
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1845 E LAKE ST, Minneapolis, MN 55407
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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 Mary Gustafson's NPI number?

The NPI number for Mary Gustafson is 1902138480. It was assigned to this individual provider in the NPPES registry on February 8, 2010.

Where is Mary Gustafson located?

Mary Gustafson practices at 1845 E Lake St, Minneapolis, MN 55407. The listed phone number is (612) 721-6215.

What is Mary Gustafson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Mary Gustafson was last updated on February 8, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.