Individual provider Active NPI

Heather Kostohryz, LPC

  • Professional Counselor
  • Moorhead, MN
National Provider Identifier
1417801820
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3267 Issued in MN
Practice address
815 37TH Ave S
Moorhead, MN 56560-5524
Phone
(701) 451-4811
Fax
(651) 925-0057
NPI assigned
Feb 23, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1521-1-15-26A ND
Professional Counselor 101YP2500X 3267 MN Primary

Addresses

Primary practice location

815 37TH Ave S
Moorhead, MN 56560-5524

Mailing address

2701 12TH Ave S
Fargo, ND 58103-8753
Phone (701) 451-4900

Other names 1

  • Heather Beeson Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260311002930 MN Practitioner - Mental Health Counselor 6002399656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2701 12TH Ave S
Fargo, ND 58103-8753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3267MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Village Family Service Center Professional CurrentSince Feb 1, 2026 Accepting new patients
Village Family Service Center CurrentSince Feb 1, 2026 Accepting new patients

Locations

815 37th Ave S
Moorhead, MN 56560
Phone (701) 451-4811

2701 12th Ave S
Fargo, ND 58103
Phone (701) 451-4865

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1771804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1417801820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 12TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038753",
            "telephone_number": "701-451-4900",
            "fax_number": "651-925-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 37TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605524",
            "telephone_number": "701-451-4811",
            "fax_number": "651-925-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTOHRYZ",
        "first_name": "HEATHER",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-23",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "1521-1-15-26A",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "3267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "BEESON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moorhead, MN

Sources for this page

Verify at the official NPI Registry.