SCOTT FISK LADC
NPI 1962207407
Counselor - Addiction (Substance Use Disorder) in Coon Rapids, MN

Q: What is Scott Fisk's NPI number?

The NPI number for Scott Fisk is 1962207407. It was assigned to this individual provider in the NPPES registry on February 18, 2025.

Q: What is Scott Fisk's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Scott Fisk was last updated on February 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.

Active since February 18, 2025PECOS Enrolled

11367 QUINCE ST NW, COON RAPIDS, MN 55448(763) 614-8381 Get Directions Write a Review

NPPES record last updated: February 18, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Scott Fisk Ladc NPPES

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

SCOTT FISK LADC (NPI 1962207407) is an individual addiction (substance use disorder) provider in Coon Rapids, Minnesota, licensed in Minnesota (304279) and active in the NPI registry since February 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1962207407

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameSCOTT FISKCredential: LADC

Location Address11367 QUINCE ST NWCoon Rapids, MN 55448-3246

Mailing Address11367 Quince St NwCoon Rapids, MN 55448-3246

Phone(763) 614-8381

Sole ProprietorYes

Medical School CMSOtherGraduated 2017

Enumeration DateFebruary 18, 2025

NPPES CertifiedFebruary 18, 2025

✔ NPI 1962207407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in MN · 304279

11367 QUINCE ST NW, Coon Rapids, MN 55448

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Scott Fisk Ladc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1456840925

PECOS Enrollment IDI20251027002576

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.

Medicare Billing Reassignment

Medicare enrollment records show Scott Fisk reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Life Interrupted Counseling Services

29 mi

Adolescent and Children Mental Health

1500 MCANDREWS RD W STE 215
Burnsville, MN 55337

Reassigned Medicare billing, Minnesota enrollment
2 clinicians in this Medicare group

NPI 1033821632 (952) 222-3002

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Scott Fisk's NPI number?

The NPI number for Scott Fisk is 1962207407. It was assigned to this individual provider in the NPPES registry on February 18, 2025.

Where is Scott Fisk located?

Scott Fisk practices at 11367 Quince St NW, Coon Rapids, MN 55448. The listed phone number is (763) 614-8381.

What is Scott Fisk's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Scott Fisk enrolled in Medicare?

Yes. Scott Fisk is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Scott Fisk's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Scott Fisk reassigns Medicare benefits to Life Interrupted Counseling Services (Burnsville, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Scott Fisk's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Scott Fisk accept?

Health plans from HealthPartners list Scott Fisk 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 Scott Fisk was last updated on February 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.