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

Nikki A Gustavson, PSYD

Individual provider Clinical Psychologist · NPI 1174122816

Nikki A Gustavson, PSYD is a Clinical Psychologist in Melville, New York. Qualified in 2009, 17 years ago. Licensed in New York.

Years since qualifying
17
Licensed in
NY
In the registry since
2020
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

275 Broadhollow Rd Ste 120
Melville, NY 11747-4863
Phone: (845) 279-5908
Fax: (845) 622-5055
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 019182 (NY)

Record details

NPI number1174122816
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD
Sole proprietorNo
NPI enumeratedOctober 23, 2020
Last updated in NPPESJune 2, 2026
Certification dateJune 2, 2026

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Melville