Edward Fosco, MS

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

LP2963 Issued in NU

Practice address

621 W Lake St Ste 350
Minneapolis, MN 55408-2952

Phone

(612) 547-9990

NPI assigned

Jan 12, 2018

Last updated

Jan 12, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1987

Medicare assignment

May accept Medicare assignment

Group practices

Lyn-Lake Psychotherapy and Wellness LTDGroup PAC ID 9638581291, 72 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lyn-Lake Psychotherapy and Wellness LTD.

  • Clinical Psychologist
  • Minneapolis, MN
  • NPI 1609355163
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515715200000",
    "number": "1205344132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 32ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W LAKE ST STE 350",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082952",
            "telephone_number": "612-547-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSCO",
        "first_name": "EDWARD",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": "LP2963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fortune Relief and Youth Empowerment Organization (Frayeo)
• Forward Motion Therapy PLLC (Forward Motion Therapy)
• Forward Path LLC
• Forward Services LLC
• Forward Transportation Services LLC
• Adam Phillip Foss, M.D.
• Rachel Foss, RN
• Katherine Nicole Fosse
• Maisie Karolyn Fossie
• Nicholas Fossland, M.D.

• Counseling Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Counseling Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.