MYSTAL RAE AXTMAN M.S., LPCC
NPI 1285775569
Counselor - Professional in Fargo, ND

Active since February 09, 2007PECOS EnrolledAccepts Medicare Assignment
4675 40TH AVE S STE 115, FARGO, ND 58104(701) 478-0906 Get Directions Write a Review

NPPES record last updated: February 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mystal Rae Axtman M.s., Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MYSTAL RAE AXTMAN M.S., LPCC (NPI 1285775569) is an individual professional provider in Fargo, North Dakota, licensed in North Dakota (472-3-1-02-164) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2001).

NPPES Registry Identity

NPI1285775569
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMYSTAL RAE AXTMANCredential: M.S., LPCC
Location Address4675 40TH AVE S STE 115Fargo, ND 58104-4592
Mailing Address4675 40th Ave S Ste 115Fargo, ND 58104-4592 · (701) 541-1547
Sole ProprietorYes
Medical School CMSOtherGraduated 2001
Enumeration DateFebruary 9, 2007
Last NPPES UpdateFebruary 15, 2023
NPPES CertifiedFebruary 15, 2023
NPI 1285775569 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in ND · 472-3-1-02-164
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 472-3-1-02-164 (ND)
4675 40TH AVE S STE 115, Fargo, ND 58104

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mystal Rae Axtman M.s., Lpcc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9436592953
PECOS Enrollment IDI20240213002796
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Professional)
4675 40TH AVE S STE 115
FARGO, ND 58104
Counselor (Professional)
4675 40TH AVE S STE 115
FARGO, ND 58104
Counselor (Professional)
4675 40TH AVE S STE 115
FARGO, ND 58104
Counselor (Mental Health)
4675 40TH AVE S STE 115
FARGO, ND 58104

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mystal Axtman's NPI number?

The NPI number for Mystal Axtman is 1285775569. It was assigned to this individual provider in the NPPES registry on February 9, 2007.

Where is Mystal Axtman located?

Mystal Axtman practices at 4675 40th Ave S Ste 115, Fargo, ND 58104. The listed phone number is (701) 478-0906.

What is Mystal Axtman's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Mystal Axtman enrolled in Medicare?

Yes. Mystal Axtman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mystal Axtman accept?

Health plans from Blue Cross Blue Shield of North Dakota and Medica list Mystal Axtman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mystal Axtman was last updated on February 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.