MS. LISA KAY GUSTAFSON MS/LCPC
NPI 1962666875
Counselor - Professional in Ottawa, IL

Active since July 10, 2008PECOS EnrolledAccepts Medicare Assignment
424 W MADISON ST, OTTAWA, IL 61350(815) 431-3022(815) 433-3980 Get Directions Write a Review

NPPES record last updated: July 10, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ms. Lisa Kay Gustafson Ms/lcpc NPPES

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

MS. LISA KAY GUSTAFSON MS/LCPC (NPI 1962666875) is an individual professional provider in Ottawa, Illinois, licensed in Illinois (180.004529) and active in the NPI registry since July 2008. She is enrolled in Medicare PECOS and is a graduate of Other (1997).

NPPES Registry Identity

NPI1962666875
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMS. LISA KAY GUSTAFSONCredential: MS/LCPC
Location Address424 W MADISON STOttawa, IL 61350-2833
Mailing Address424 W Madison StOttawa, IL 61350-2833 · (815) 431-3022 · Fax (815) 433-3980
Fax(815) 433-3980
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateJuly 10, 2008
✔ NPI 1962666875 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 IL · 180.004529
424 W MADISON ST, Ottawa, IL 61350

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Lisa Kay Gustafson Ms/lcpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5799215950
PECOS Enrollment IDI20250204001705
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Lisa Gustafson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Family Medicine
1401 EAST 12TH STREET
Mendota, IL 61342
  • Reassigned Medicare billing, Illinois enrollment
  • 95 clinicians in this Medicare group

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

Other Providers at the Same Location NPPES 10

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

Social Worker (Clinical)
424 W MADISON ST
OTTAWA, IL 61350
Social Worker (Clinical)
424 W MADISON ST
OTTAWA, IL 61350
Clinic/Center (Mental Health (Including Community Mental Health Center))
424 W MADISON ST
OTTAWA, IL 61350
Counselor
424 W MADISON ST
OTTAWA, IL 61350
Counselor (Professional)
424 W MADISON ST
OTTAWA, IL 61350
Social Worker (Clinical)
424 W MADISON ST
OTTAWA, IL 61350
Social Worker (Clinical)
424 W MADISON ST
OTTAWA, IL 61350
Voluntary or Charitable
424 W MADISON ST
OTTAWA, IL 61350

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 Lisa Gustafson's NPI number?

The NPI number for Lisa Gustafson is 1962666875. It was assigned to this individual provider in the NPPES registry on July 10, 2008.

Where is Lisa Gustafson located?

Lisa Gustafson practices at 424 W Madison St, Ottawa, IL 61350. The listed phone number is (815) 431-3022.

What is Lisa Gustafson's specialty?

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

Is Lisa Gustafson enrolled in Medicare?

Yes. Lisa Gustafson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Lisa Gustafson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Gustafson reassigns Medicare benefits to Mendota Community Hospital (Mendota, IL). The 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 Lisa Gustafson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Gustafson accept?

Health plans from Oscar Health list Lisa Gustafson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Gustafson was last updated on July 10, 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.