Alexander Bascom
Individual provider Active NPI Professional Counselor · Saint Paul, MN
NPI 1821707332 · NPPES record last updated Nov 23, 2022
Key facts
- NPI
- 1821707332
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- CC03524 (MN)
- Practice address
- 451 Lexington Pkwy N
Saint Paul, MN 55104-4636 - Phone
- (651) 280-2310
- NPI assigned
- Nov 23, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Amherst H. Wilder Foundation
Practice addresses (Care Compare)
451 Lexington Pkwy N
Saint Paul, MN 55104-4636
Phone (651) 280-2310
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231220000902 | MN | Practitioner - Mental Health Counselor | 1153771977 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC03524 | MN | MD | Professional Counselor |
| 3524 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amherst H. Wilder Foundation | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CC03524 | MN | Yes |
Addresses
Primary practice location
451 Lexington Pkwy N
Saint Paul, MN 55104-4636
Mailing address
451 Lexington Pkwy N
Saint Paul, MN 55104-4636
Other providers in Saint Paul, MN
- My-Tien Bartha
- Paige Bartholome
- Sarah Lea Bartlett
- Keara Barton
- Donna Bartow
- Mohamed Bashe
- Abyan Bashir
- Rowda Madad Bashir
- Shukri Bashir
- Basra Home Health Care LLC
All providers in Saint Paul, MN · Professional Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.