Skip Navigation Link. Please press insert + down arrow if jaws does not start reading the content.

Provider Information for 1548285158


The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

Mr. MICHAEL DEAN GUSACK LPC


Sex: Male

NPI: 1548285158
Last Updated: 2020-05-27
Certification Date: 2020-05-27

Details

NameValue
NPI1548285158
Enumeration Date2006-07-13
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 645 ELDORADO BLVD APT 1213
BROOMFIELD, CO 80021-8835
United States

Phone: 850-737-0022 | Fax:
 
Primary Practice Address 645 ELDORADO BLVD APT 1213
BROOMFIELD, CO 80021-8835
United States

Phone: 850-737-0022 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthCOLPC.0015851