DR. MARK CARL LYSNE (PHD) – Clinical Psychologist, NPI 1366530008

DR. MARK CARL LYSNE (PHD) is a healthcare provider. based in Fergus falls, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. LP4575 (MN). The NPI Number for DR. MARK CARL LYSNE (PHD) is 1366530008

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARK CARL LYSNE (PHD)
NPI
1366530008
Phone
(218) 998-3123
Address
225 W CAVOUR AVE
Enumeration Date
10 October 2006
Last Update Date
2 May 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2189983123
Graduation Year
2002 (24 years ago)
PAC ID
3173525862
Professional Enrollment ID
I20070208000651
Address ID
MN565372140FE225XXAVEX411
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,120 CLINICAL PSYCHOLOGIST in MN

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Provider Addresses for DR. MARK CARL LYSNE (PHD)

  • 225, West Cavour Avenue, Downtown, Fergus Falls, Otter Tail County, Minnesota, 56537, United States

    P.O. BOX 713

    FERGUS FALLS, MN 565372103

    Phone: (218) 998-3123

    Fax: (218) 998-3126

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-02-08

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070208000651IClinical PsychologistMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 56537)

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Reviews

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Frequently asked questions

Does DR. MARK CARL LYSNE (PHD) have a public NPI I can cite?
Public records show DR. MARK CARL LYSNE (PHD) under NPI 1366530008.
Is DR. MARK CARL LYSNE (PHD)'s NPI status active today?
Active status means DR. MARK CARL LYSNE (PHD)'s NPI record is not deactivated in the public file.
What type of care does DR. MARK CARL LYSNE (PHD) provide?
DR. MARK CARL LYSNE (PHD)'s profile centers on Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. MARK CARL LYSNE (PHD)?
DR. MARK CARL LYSNE (PHD) shows a connection to Fergus Falls, Minnesota in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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