BLOSSOM WHOLE FAMILY THERAPY & CHILD PSYCHOLOGY CENTER, PLLC (NPI# 1194059642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194059642 |
| Entity Type | Organization |
| Organization Name | BLOSSOM WHOLE FAMILY THERAPY & CHILD PSYCHOLOGY CENTER, PLLC |
| Other Organization Name | BLOSSOM CHILD PSYCHOLOGY & BEHAVIORAL HEALTH CENTER, PLLC |
| Practice Address |
11900 Wayzata Blvd Suite 216e Minnetonka MN 55305-2031 |
| Practice Telephone | 9525453300 |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2017-01-10 |
| Authorized Official Name | DR. GRETCHEN LEWIS-SNYDER (CHIEF MANAGER/PSYCHOLOGIST) |
| Authorized Official Telephone | 6127195422 |
| Authorized Official Credential | PHD, LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
LP4976 | MN | Ambulatory Health Care Facilities |
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
LP4976 | MN | Ambulatory Health Care Facilities |
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
LP4976 | MN | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Blossom Child Psychology & Behavioral Health Center, PLLC | Former Legal Business Name - Organization |
| Street Address |
11900 WAYZATA BLVD SUITE 216E |
| City | MINNETONKA |
| State | MN |
| Zip Code | 55305-2031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477531424 | Joan W. Lally | Social Worker | 11900 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-2031 | 2006-01-09 |
| 1457803413 | Dawn Mckee | Massage Therapist | 11900 Wayzata Blvd, Suite 110, Minnetonka, MN 55305-2031 | 2016-10-25 |
| 1568916187 | Karla Buerkle | Psychologist | 11900 Wayzata Blvd, Ste 216i, Minnetonka, MN 55305-2031 | 2016-08-11 |
| 1831576453 | Center for Women's Group Therapy | Counselor | 11900 Wayzata Blvd, Ste 200, Minnetonka, MN 55305-2031 | 2015-05-04 |
| 1164834214 | Gregory Ripley | Acupuncturist | 11900 Wayzata Blvd, Suite 110, Minnetonka, MN 55305-2031 | 2014-05-23 |
| 1922448620 | Avalon Programs, LLC | Counselor | 11900 Wayzata Blvd, Suite 100, Minnetonka, MN 55305-2031 | 2013-06-27 |
| 1124366927 | Jennifer Bennett | Psychologist | 11900 Wayzata Blvd, Suite 214, Minnetonka, MN 55305-2031 | 2013-01-29 |
| 1982926515 | Sarah L. Sander Psy.d.,lp, LLC | Psychologist | 11900 Wayzata Blvd, Suite 132, Minnetonka, MN 55305-2031 | 2010-02-23 |
| 1841522901 | Moniza Psychological Services | Psychologist | 11900 Wayzata Blvd, Suite 132, Minnetonka, MN 55305-2031 | 2010-01-31 |
| 1174714851 | Gretchen Ranee Lewis-snyder | Psychologist | 11900 Wayzata Blvd, Suite 216e, Minnetonka, MN 55305-2031 | 2007-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255948584 | Sober Living Connection | Substance Abuse Rehabilitation Facility | 11115 Minnetonka Blvd, Hopkins, MN 55305 | 2020-09-30 |
| 1649739103 | Gabriel Douglas Orem | Occupational Therapist | 10653 Waysata Blvd., Suite 200, Minnetonka, MN 55305 | 2019-03-14 |
| 1750863106 | Andrea Haglin | Counselor | 10505 Wayzata Blvd. Ste 101, Minnetonka, MN 55305 | 2018-09-02 |
| 1770934499 | Acme Transportation | Private Vehicle | 11356 Cedar Pointe Dr, Minnetonka, MN 55305 | 2016-06-23 |
| 1841641743 | Laine Cecily Hartwell Epp | Counselor | 1300 Wayzata Blvd., Ste. 400, Minnetonka, MN 55305 | 2016-06-22 |
| 1407217367 | Larissa Vados | Acupuncturist | 11654 Wayzata Blvd, Minnetonka, MN 55305 | 2016-03-18 |
| 1548658982 | Irene Grudsky | Contractor | 10550 Wayzata Blvd, Minnetonka, MN 55305 | 2015-01-08 |
| 1780093500 | Lalaine Arbuthnot Ortlieb | Counselor | 11900 Wayzata Blvd, Suite 100, Minnetonka, MN 55305 | 2014-08-06 |
| 1235472275 | Katherine Thistle Rivard | Dietitian, Registered | 11240 Cedar Pointe Drive North, Minnetonka, MN 55305 | 2013-03-28 |
| 1558633784 | Vickie Lynn Schaefer | Social Worker | 10505 Wayzata Blve Suite 101, Minnetonka, MN 55305 | 2012-02-03 |
| Find all providers in zip 55305 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
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| 1568079374 | Midway Counseling Services LLC | Clinic/Center | 1410 9th Ave S Apt 306, Saint Cloud, MN 56301-5787 | 2020-09-25 |
| 1801409099 | Star Autism Center | Clinic/Center | 3333 W Division St Ste 116, Saint Cloud, MN 56301-4548 | 2020-08-26 |
| 1851900484 | Iron Range Behavioral Services LLC | Clinic/Center | 817 S 5th Ave, Virginia, MN 55792-2804 | 2020-07-29 |
| 1184240103 | Adhd&u | Clinic/Center | 2196 Carter Ave, Saint Paul, MN 55108-1709 | 2020-06-25 |
| 1033744008 | Star Health Services | Clinic/Center | 3055 Old High 8, Saint Anthony, MN 55418 | 2020-03-10 |
| 1659906071 | Amoud Center Inc | Clinic/Center | 1925 Portland Ave, Minneapolis, MN 55404-2713 | 2020-03-05 |
| 1164055026 | Moonlight Support Services LLC | Clinic/Center | 3110 Old Hwy 8, 206, Roseville, MN 55113-5511 | 2020-02-19 |
| 1285279554 | Metro Therapy Center Inc | Clinic/Center | 2520 Pillsbury Ave S Apt 306, Minneapolis, MN 55404-4208 | 2019-11-11 |
| 1710536081 | Blu Care Inc | Clinic/Center | 2910 Pillsbury Ave S Ste 338, Minneapolis, MN 55408 | 2019-09-09 |
| Find all providers with the same taxonomy | ||||
| City | MINNETONKA |
| Zip Code | 55305 |
Please comment or provide details below to improve the information on BLOSSOM WHOLE FAMILY THERAPY & CHILD PSYCHOLOGY CENTER, PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.