NPIMap

Organization Active NPI

Nystrom & Associates Counseling Wi., S.C.

Doing business as Sagent Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fargo, ND
National Provider Identifier
1104549047
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
NYSTROM & ASSOCIATES COUNSELING WI., S.C.
Doing business as
Sagent Behavioral Health
Practice address
5354 42ND St S
Fargo, ND 58104-4032
Phone
(844) 697-8766
NPI assigned
Sep 26, 2022
Last updated
May 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ann Eiden
Title
VP of Corporate Services
Phone
(651) 379-1750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

5354 42ND St S
Fargo, ND 58104-4032

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 379-1750

Other names 1

  • Sagent Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230321002230 ND Part B Supplier - Clinic/Group Practice 1052729464 Receives reassigned benefits from 19 practitioners
Practice locations: Fargo, ND

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

5354 42nd St S
Fargo, ND 58104
Phone (844) 697-8766

2005 Highland Ave
Ste B
Eau Claire, WI 54701
Phone (866) 559-3060

480 Pilgrim Way
#1300A
Green Bay, WI 54304
Phone (920) 610-5119

1001 Fourier Dr
Ste 200
Madison, WI 53717
Phone (608) 740-2001

Practitioners & affiliated clinicians

Practitioners 189

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 189

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779062400000",
    "number": "1104549047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-379-1750",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5354 42ND ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044032",
            "telephone_number": "844-697-8766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYSTROM & ASSOCIATES COUNSELING WI., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-26",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A",
        "authorized_official_last_name": "EIDEN",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "VP OF CORPORATE SERVICES",
        "authorized_official_telephone_number": "651-379-1750"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sagent Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.