NPIMap

Organization Active NPI

Hozho Psychiatry & Wellness PLLC

  • Clinic/Center
  • Eagan, MN
National Provider Identifier
1104653161
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HOZHO PSYCHIATRY & WELLNESS PLLC
Practice address
860 Blue Gentian Rd Ste 200
Eagan, MN 55121-1567
Phone
(612) 619-0021
NPI assigned
Sep 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Melvina Deneal Bissonette, MDNPI 1417214644
Title
Owner
Phone
(612) 217-1737

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

860 Blue Gentian Rd Ste 200
Eagan, MN 55121-1567

Mailing address

860 Blue Gentian Rd Ste 200
Eagan, MN 55121-1567
Phone (612) 217-1737

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749772800000",
    "number": "1104653161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 BLUE GENTIAN RD STE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211567",
            "telephone_number": "612-217-1737",
            "fax_number": "612-457-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 BLUE GENTIAN RD STE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211567",
            "telephone_number": "612-619-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOZHO PSYCHIATRY & WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A",
        "authorized_official_last_name": "BISSONETTE",
        "authorized_official_first_name": "MELVINA",
        "authorized_official_middle_name": "DENEAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-217-1737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.