Individual
HOWARD GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
324 N PARK AVE, INDIANAPOLIS, IN 46202-3632
(317) 714-7667
(317) 634-0253
Mailing address
324 N PARK AVE, INDIANAPOLIS, IN 46202-3632
(317) 714-7667
(317) 634-0253
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87001536A
IN
1041C0700X
Clinical Social Worker
34001491A
IN
Other
Enumeration date
04/17/2015
Last updated
04/17/2015
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