Kassondra Lorol Gustafson, LPCC in Willmar, MN

Kassondra Lorol Gustafson, LPCC is a medicare enrolled "Counselor - Mental Health" provider in Willmar, Minnesota. Her current practice location is 201 28th Ave Sw, Willmar, Minnesota. You can reach out to her office (for appointments etc.) via phone at (320) 214-8558.

Kassondra Lorol Gustafson is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1831794973.

Contact Information

	Kassondra Lorol Gustafson, LPCC
	201 28th Ave Sw, Willmar, MN 56201-5241
	(320) 214-8558
	(320) 235-2733

Map and Direction

Healthcare Provider's Profile

Full Name	Kassondra Lorol Gustafson
Gender	Female
Speciality	Counselor - Mental Health
Location	201 28th Ave Sw, Willmar, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1831794973
Provider Enumeration Date: 12/04/2020
Last Update Date: 09/05/2024

Medicare PECOS Information:

PECOS PAC ID: 1557893195
Enrollment ID: I20241021001413

Medical Identifiers

Medical identifiers for Kassondra Lorol Gustafson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1831794973	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kassondra Lorol Gustafson allows following entities to bill medicare on her behalf.

Entity Name	Nystrom & Associates Ltd
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396750188 PECOS PAC ID: 6406752492 Enrollment ID: O20031210000592

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kassondra Lorol Gustafson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kassondra Lorol Gustafson, LPCC 1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112-1789 Ph: () -	Kassondra Lorol Gustafson, LPCC 201 28th Ave Sw, Willmar, MN 56201-5241 Ph: (320) 214-8558

Reviews and Comments

Counselor in Willmar, MN

Ms. Cheryl Lee Walter, BS, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 328 3rd St Sw, Willmar, MN 56201 Phone: 320-231-9763
Michelle Beeman, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 214 4th St Sw, Willmar, MN 56201 Phone: 320-214-8558 Fax: 320-235-2733
Jaime L Larson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2160 60th Ave Ne, Willmar, MN 56201 Phone: 507-299-0436
Lindsey Maria Borresen, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2320 Highway 12 E Ste 2, Willmar, MN 56201 Phone: 320-214-9692
Misty Nelson, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 309 7th St Nw, Willmar, MN 56201 Phone: 320-214-7744
Jessica Lee Bakken, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 2120 60th Ave Ne, Willmar, MN 56201 Phone: 320-905-4345
Carmelita Regina Privatt, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1125 6th St Se, Willmar, MN 56201 Phone: 320-235-4613 Fax: 855-625-7406

Kassondra Lorol Gustafson, LPCC - Medicare Counselor in Willmar, MN