Mystal Rae Axtman, MS, LPCC in Fargo, ND - Medicare Counselor Provider

Mystal Rae Axtman, MS, LPCC is a medicare enrolled "Counselor - Professional" provider in Fargo, North Dakota. Her current practice location is 4675 40th Ave S Ste 115, Fargo, North Dakota. You can reach out to her office (for appointments etc.) via phone at (701) 478-0906.

Mystal Rae Axtman is licensed to practice in North Dakota (license number 472-3-1-02-164) 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 1285775569.

Contact Information

	Mystal Rae Axtman, MS, LPCC
	4675 40th Ave S Ste 115, Fargo, ND 58104-4592
	(701) 478-0906
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mystal Rae Axtman
Gender	Female
Speciality	Counselor - Professional
Location	4675 40th Ave S Ste 115, Fargo, North Dakota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1285775569
Provider Enumeration Date: 02/09/2007
Last Update Date: 02/15/2023

Medicare PECOS Information:

PECOS PAC ID: 9436592953
Enrollment ID: I20240213002796

Medical Identifiers

Medical identifiers for Mystal Rae Axtman such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1285775569	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	472-3-1-02-164 (North Dakota)	Secondary
101YP2500X	Counselor - Professional	472-3-1-02-164 (North Dakota)	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. Mystal Rae Axtman allows following entities to bill medicare on her behalf.

Entity Name	Inner Light Counseling Services Ltd
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740861954 PECOS PAC ID: 4082057500 Enrollment ID: O20240212001632

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. Mystal Rae Axtman 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
Mystal Rae Axtman, MS, LPCC 4675 40th Ave S Ste 115, Fargo, ND 58104-4592 Ph: (701) 541-1547	Mystal Rae Axtman, MS, LPCC 4675 40th Ave S Ste 115, Fargo, ND 58104-4592 Ph: (701) 478-0906

Reviews and Comments

Counselor in Fargo, ND

Rachel A Blumhardt, Counselor Medicare: Medicare Enrolled Practice Location: 2701 12th Ave S, Fargo, ND 58103 Phone: 701-451-4900 Fax: 651-925-0057
Sarah Klimek, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2311 45th St S Ste 4a, Fargo, ND 58104 Phone: 701-532-1477
Aleece Jung, LAPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3401 45th St S, Fargo, ND 58104 Phone: 701-356-4384 Fax: 701-356-4383
Mary Beth Stensgard, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3309 Fiechtner Dr S Ste H, Fargo, ND 58103 Phone: 701-261-6539
Kaitlin Doyle, LAPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2701 12th Ave S, Fargo, ND 58103 Phone: 701-451-4900 Fax: 651-925-0057
Lisa Ann Mastel, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1720 University Dr S, Fargo, ND 58103 Phone: 701-461-5308 Fax: 701-461-5649
Dale A Carrier, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2624 9th Ave S, Fargo, ND 58103 Phone: 701-298-4500 Fax: 701-298-4400

Mystal Rae Axtman, MS, LPCC - Medicare Counselor in Fargo, ND