Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blossom Whole Family Therapy & Child Psychology Center, PLLC

Organization Clinical Child & Adolescent Psychologist · NPI 1194059642

Blossom Whole Family Therapy & Child Psychology Center, PLLC is a Clinical Child & Adolescent Psychologist in Minnetonka, Minnesota. Licensed in Minnesota. Registered with an NPI since 2009.

Licensed in
MN
In the registry since
2009
Specialties on file
4
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10505 Wayzata Blvd Ste 103
Minnetonka, MN 55305-1507
Phone: (952) 545-3300
Fax: (952) 545-3300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adolescent and Children Mental Health Clinic/Center (primary) Taxonomy 261QM0855X · Licence LP4976 (MN)
Clinical Child & Adolescent Psychologist Taxonomy 103TC2200X
Mental Health Clinic/Center (Including Community Mental Health Center) Taxonomy 261QM0801X · Licence LP4976 (MN)
Adult Mental Health Clinic/Center Taxonomy 261QM0850X · Licence LP4976 (MN)

Record details

NPI number1194059642
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gretchen Lewis-Snyder — Chief Manager/Psychologist · (612) 719-5422
Other names Blossom Child Psychology & Behavioral Health Center, Pllc; Blossom Child Psychology & Behavioral Health Center, Pllc
NPI enumeratedSeptember 30, 2009
Last updated in NPPESAugust 28, 2023
Certification dateAugust 28, 2023
Mailing address10505 Wayzata Blvd Ste 103, Minnetonka, MN 55305-1507

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