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

Individual provider Mental Health Counselor · NPI 1851778757

Wayne Eric Gustafson, DMIN is a Mental Health Counselor in Ithaca, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

224 Forest Home Dr
Ithaca, NY 14850-2747
Phone: (607) 857-0003
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LMHC 002006 (NY)
Pastoral Counselor Taxonomy 101YP1600X

Record details

NPI number1851778757
Entity typeIndividual (Type 1)
GenderMale
Credentials DMIN
Sole proprietorYes
NPI enumeratedApril 29, 2015
Last updated in NPPESApril 29, 2015
Mailing address201 Rachel Carson Way, Ithaca, NY 14850-8402

Other providers in Ithaca