Ms Trista M Gottwalt, MS, LADC in Coon Rapids, MN

Ms Trista M Gottwalt, MS, LADC is a medicare enrolled "Counselor - Mental Health" provider in Coon Rapids, Minnesota. Her current practice location is 2140 Northdale Blvd Nw # 220, Coon Rapids, Minnesota. You can reach out to her office (for appointments etc.) via phone at (763) 537-6000.

Ms Trista M Gottwalt is licensed to practice in Minnesota (license number 4115) 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 1184291049.

Contact Information

	Ms Trista M Gottwalt, MS, LADC
	2140 Northdale Blvd Nw # 220, Coon Rapids, MN 55433-3005
	(763) 537-6000
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Ms Trista M Gottwalt
Gender	Female
Speciality	Counselor - Mental Health
Location	2140 Northdale Blvd Nw # 220, Coon Rapids, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1184291049
Provider Enumeration Date: 06/09/2021
Last Update Date: 11/13/2023

Medicare PECOS Information:

PECOS PAC ID: 5698110567
Enrollment ID: I20240301000682

Medical Identifiers

Medical identifiers for Ms Trista M Gottwalt such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184291049	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	306045 (Minnesota)	Secondary
101YM0800X	Counselor - Mental Health	4115 (Minnesota)	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. Ms Trista M Gottwalt allows following entities to bill medicare on her behalf.

Entity Name	Nura Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1750316014 PECOS PAC ID: 2769378942 Enrollment ID: O20040322000281

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. Ms Trista M Gottwalt 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
Ms Trista M Gottwalt, MS, LADC 13313 Delores Dr, Pierz, MN 56364-4238 Ph: (320) 360-1810	Ms Trista M Gottwalt, MS, LADC 2140 Northdale Blvd Nw # 220, Coon Rapids, MN 55433-3005 Ph: (763) 537-6000

Reviews and Comments

Counselor in Coon Rapids, MN

Abigail Fletcher, Counselor Medicare: Medicare Enrolled Practice Location: 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433 Phone: 763-767-3350
Mrs. Nikisha Lynnette Simmons-maclin, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10026 University Ave Nw Ste 103, Coon Rapids, MN 55448 Phone: 612-636-9677
Adam Palowski, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 10077 Dogwood St Nw, Coon Rapids, MN 55448 Phone: 612-676-1604
Charles Lochner, MA Counselor Medicare: Medicare Enrolled Practice Location: 11660 Round Lake Blvd Nw, Coon Rapids, MN 55433 Phone: 763-767-3350 Fax: 763-767-0912
Ms. Kristal Ficzeri, MA Counselor Medicare: Medicare Enrolled Practice Location: 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433 Phone: 763-767-3350
Calsi Gilbertson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 11660 Round Lake Blvd Nw, Coon Rapids, MN 55433 Phone: 763-767-3350
Hong Fa Thao, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 9120 Springbrook Dr Nw, Coon Rapids, MN 55433 Phone: 612-767-7222

Ms Trista M Gottwalt, MS, LADC - Medicare Counselor in Coon Rapids, MN