National Provider Identifier
Theresa Gustaveson, LMSW
Theresa Gustaveson, LMSW is listed in the NPPES registry with a primary specialty of Social Worker in Ithaca, NY and a listed phone number of (607) 360-6602.
Profile Overview
- NPI
- 1770447179
- Provider Type
- Individual
- Primary Specialty
- Social Worker
- Enumeration Date
- December 11, 2025
- Last Updated
- December 11, 2025
Practice Location
- 950 Danby RD Ste 201-M
- Ithaca, NY 14850-5778
Phone: (607) 360-6602
Mailing Address
- 1182 Chenango St
- Binghamton, NY 13901-1653
Specialties
- Social Worker (104100000X)
Full Record
- NPI
- 1770447179
- Entity Type
- Individual
- Last Name
- Gustaveson
- First Name
- Theresa
- Credential
- LMSW
- Mailing Street Address
- 1182 Chenango St
- Mailing City
- Binghamton
- Mailing State
- NY
- Mailing ZIP Code
- 13901-1653
- Mailing Country
- US
- Mailing Phone
- (607) 772-6904
- Practice Street Address
- 950 Danby RD Ste 201-M
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-5778
- Practice Country
- US
- Practice Phone
- (607) 360-6602
- Enumeration Date
- December 11, 2025
- Last Updated
- December 11, 2025
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- December 11, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Social Worker (104100000X)
- Other Identifiers
- 02997780 (NY)