Active NPI
Tiffany Lynn Madson, LPCC
- Mental Health Counselor
- Baxter, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CC04185
- Practice address
- 13045 Falcon Dr Ste 100
Baxter, MN 56425-4201 - Phone
- (218) 829-9307
- NPI assigned
- Mar 25, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC04185 | MN | Primary |
Addresses
Primary practice location
13045 Falcon Dr Ste 100
Baxter, MN 56425-4201
Mailing address
19280 Grave Lake Rd
Brainerd, MN 56401-4735
Phone (612) 750-0291
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240506004312 | MN | Practitioner - Mental Health Counselor | 6507206646 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Nystrom and Associates LTD
Practice addresses (Care Compare)
13045 Falcon Dr
Suite 100
Baxter, MN 56425-4201
Phone (218) 829-9307
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC04185 | MN | MD | Mental Health Counselor |
| 4185 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nystrom & Associates, LTD | Current | Accepting new patients |
Locations
13045 Falcon Dr
#100
Brainerd, MN 56425
Phone (218) 203-6282
1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718
1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704
Organizations & group practices 1
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": "1711324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1831949833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19280 GRAVE LAKE RD",
"city": "BRAINERD",
"state": "MN",
"postal_code": "564014735",
"telephone_number": "612-750-0291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13045 FALCON DR STE 100",
"city": "BAXTER",
"state": "MN",
"postal_code": "564254201",
"telephone_number": "218-829-9307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADSON",
"first_name": "TIFFANY",
"middle_name": "LYNN",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-25",
"last_updated": "2024-03-25",
"certification_date": "2024-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "CC04185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baxter, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.