Healthcare Provider Details

I. General information

NPI: 1376992099
Provider Name (Legal Business Name): CAITLYN B GUNST MHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAITLYN C BUSCHER

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S NAPERVILLE RD
WHEATON IL
60187-5423
US

IV. Provider business mailing address

315 S NAPERVILLE RD
WHEATON IL
60187-5423
US

V. Phone/Fax

Practice location:
  • Phone: 630-492-1388
  • Fax:
Mailing address:
  • Phone: 630-492-1388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166.001229
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: