Healthcare Provider Details

I. General information

NPI: 1588568463
Provider Name (Legal Business Name): ALLISON ANNE GUSE MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 PAYNE AVE
SAINT PAUL MN
55130-3218
US

IV. Provider business mailing address

2538 4TH AVE E
NORTH ST PAUL MN
55109-3022
US

V. Phone/Fax

Practice location:
  • Phone: 651-384-2272
  • Fax:
Mailing address:
  • Phone: 763-516-4308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number32687
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: