Mark Carl Lysne, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP4575 Issued in MN

Practice address

225 W Cavour Ave
Fergus Falls, MN 56537-2103

Phone

(218) 998-3123

Fax

(218) 998-3126

NPI assigned

Oct 10, 2006

Last updated

May 2, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• Lysne Consulting & Counseling

  • Clinical Psychologist
  • Fergus Falls, MN
  • NPI 1104477819
  Medicare reassignment NPD Authorized official
• Generations, Inc Counseling Associates

  • Clinical Psychologist
  • Fergus Falls, MN
  • NPI 1780600189
  Authorized official Same address or phone

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1366530008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W CAVOUR AVE",
            "address_2": "P.O. BOX 713",
            "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": "MARK",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lutheran Social Service of Minnesota
• Jessica Jean Lyngaas, LPN
• Jodylee Katharine Lyons, LPN
• Lysne Consulting & Counseling
• Christianne M Lysne, PHD
• Ala Lora Lysyk Smith, D.C.
• Ashlyn Marie Ma, PHARMD
• Jayme M Mace, D.M.D
• David Jerome Mach, DO
• Lane Marie Magnusson, RN PHN

• 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.