Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Emily Rose Gustafson, LICSW

Individual provider Clinical Social Worker · NPI 1871483248

Emily Rose Gustafson, LICSW is a Clinical Social Worker in Ramsey, Minnesota. Qualified in 2020, 6 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in Minnesota.

Years since qualifying
6
Licensed in
MN
In the registry since
2025
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

15243 Nowthen Blvd NW
Ramsey, MN 55303-6138
Phone: (612) 900-0233
Fax: (866) 627-0910
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2705 Bunker Lake Blvd Nw Ste 112, Andover, MN 55304-3785 — (612) 900-0233

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 19227 (MN)

Record details

NPI number1871483248
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedJuly 8, 2025
Last updated in NPPESJuly 8, 2025
Certification dateJuly 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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