Nystrom & Associates Counseling Wi., S.C.

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Fargo, ND

NPI 1104549047 · NPPES record last updated May 18, 2026

Key facts

NPI
1104549047
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Legal business name
NYSTROM & ASSOCIATES COUNSELING WI., S.C.
Practice address
5354 42ND St S
Fargo, ND 58104-4032
Phone
(844) 697-8766
NPI assigned
Sep 26, 2022
Organization subpart
No

Authorized official

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

Other NPIs with the same Medicare PAC ID 1

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

Practitioners 191

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 191

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ND

Medicare enrollment records

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

National Provider Directory

Locations

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

19 W 1st St
Fond du Lac, WI 54935
Phone (920) 922-7760

2501 Hanley Rd
Ste 201
Hudson, WI 54016
Phone (534) 544-5247

201 Main St
Ste 500
La Crosse, WI 54601
Phone (608) 668-4005

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

Specialties & licenses

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

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

  • Sagent Behavioral Health Doing business as

Other providers in Fargo, ND

All providers in Fargo, ND · Mental Health Clinic/Center (Including Community Mental Health Center) in North Dakota

Sources for this page

Verify at the official NPI Registry.