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General NPI Number Information
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NPI Number | 1295403244
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Entity Type | Individual
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Provider Name | BRENT GUST MSW, APSW
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Gender | Male
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Dates
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Enumeration Date | 09/03/2021
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 3703 OAKWOOD HILLS PKWY STE 100
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4458
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Country | US
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Telephone | 534-444-4562
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Fax |
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Provider Business Mailing Address
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Address Line | 3703 OAKWOOD HILLS PKWY STE 100
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4458
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 131760-121
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License Number State | WI
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