Christianne M Lysne, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4844 Issued in MN

Practice address

225 W Cavour Ave
Fergus Falls, MN 56537-2103

Phone

(218) 998-3123

Fax

(218) 998-3126

NPI assigned

May 24, 2007

Last updated

May 2, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Christianne M Garsault Former name

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• The Blue Lotus, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fergus Falls, MN
  • NPI 1760944615
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1316158439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W CAVOUR AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372103",
            "telephone_number": "218-998-3123",
            "fax_number": "218-998-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W CAVOUR AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372103",
            "telephone_number": "218-998-3123",
            "fax_number": "218-998-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYSNE",
        "first_name": "CHRISTIANNE",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "4844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404118000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTIANNE",
            "last_name": "GARSAULT",
            "middle_name": "M",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lutheran Brethren Woodland Lodge, Inc. (LB Woodland Lodge)
• Lutheran Social Service of Minnesota
• Jessica Jean Lyngaas, LPN
• Jodylee Katharine Lyons, LPN
• Lysne Consulting & Counseling
• Mark Carl Lysne, PHD
• Ala Lora Lysyk Smith, D.C.
• Ashlyn Marie Ma, PHARMD
• Jayme M Mace, D.M.D
• David Jerome Mach, DO

• Clinical Psychologist in Fergus Falls, MN
• Providers in Fergus Falls, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; 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.