Individual provider Active NPI

Katherine Lea Staszko, LPCC, LPCC-S

  • Professional Counselor
  • Moorhead, MN
National Provider Identifier
1770094229
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3138 Issued in MN
Practice address
2405 8TH St S Ste 200
Moorhead, MN 56560-4200
Phone
(218) 331-4866
Fax
(218) 331-4867
NPI assigned
Oct 23, 2017
Last updated
Feb 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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 1023-9-1-19-402 ND
Professional Counselor 101YP2500X 3138 MN Primary

Addresses

Primary practice location

2405 8TH St S Ste 200
Moorhead, MN 56560-4200

Mailing address

1900 Silver Lake Rd NW
New Brighton, MN 55112-1786
Phone (651) 628-9566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250310001881 MN Practitioner - Mental Health Counselor 2769903558 Reassigns benefits to 1 organization
I20250310003181 ND Practitioner - Mental Health Counselor 2769903558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

2405 8TH St S
Suite 200
Moorhead, MN 56560-4200
Phone (218) 331-4866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3138MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Feb 24, 2025 Accepting new patients
Nystrom & Associates, LTD CurrentSince Feb 24, 2025 Accepting new patients
Family Support Services Inc. Mental Health CurrentSince Feb 24, 2025 Accepting new patients
Pediatric Therapy Partners, Inc. PastSince Aug 1, 2019 Accepting new patients

Locations

2405 8th St S
Ste 200
Moorhead, MN 56560
Phone (218) 331-4866

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

5354 42nd St S
Ste B
Fargo, ND 58104
Phone (701) 501-8014

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1770094229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 8TH ST S STE 200",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565604200",
            "telephone_number": "218-331-4866",
            "fax_number": "218-331-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASZKO",
        "first_name": "KATHERINE",
        "middle_name": "LEA",
        "credential": "LPCC, LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "1023-9-1-19-402",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "3138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

Verify at the official NPI Registry.