Individual
KATY GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
4424 MONTGOMERY AVE STE 201, BETHESDA, MD 20814-4436
(240) 560-2261
Mailing address
5518 CHESHIRE MEADOWS WAY, FAIRFAX, VA 22032-3226
(402) 750-3668
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC12771
MD
101YM0800X
Mental Health Counselor
LGP9970
MD
Other
Enumeration date
01/03/2020
Last updated
05/08/2024
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