Individual ProviderKaren M GustafsonCounselorBehavioral Health & Social Service ProvidersPractice Address333 South 132d Street, Omaha, NE 68154(402) 330-2024PECOS EnrollmentBased on the most recent information from CMS, provider Karen M Gustafson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:51 AM.Profile DetailsProvider ID1750472189Provider TypeIndividualFull NameGustafson, Karen MTitleMrs.CredentialLMHPGenderFemaleSole ProprietorNoEnumeration Date9/28/2006Last Updated12/16/2011Contact InformationPractice LocationPractice Address333 South 132d Street, Omaha, NE 68154Phone(402) 330-2024Fax(402) 697-7019Mailing LocationMailing Address333 South 132d Street, Omaha, NE 68154Phone(402) 330-2024Fax(402) 697-7019Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense920NebraskaCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense2002NebraskaCode101YP2500XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense2002NebraskaProvider IdentifiersIDDescriptionIssuerID13006DescriptionOtherIssuerMIDLANDS CHOICENebraskaID84887DescriptionOtherIssuerBCBSNebraska