Melissa Wetterlund, MA, LP, LMFT

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP 5014 Issued in MN

Practice address

4255 Pheasant Ridge Dr NE Ste 412
Blaine, MN 55449-5066

Phone

(763) 703-3749

Fax

(763) 703-3725

NPI assigned

Feb 13, 2007

Last updated

Apr 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Melissa K Wetterlund LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Blaine, MN
  • NPI 1588309181
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1659413599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 PHEASANT RIDGE DR NE STE 412",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495066",
            "telephone_number": "763-703-3749",
            "fax_number": "651-393-2835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 PHEASANT RIDGE DR NE STE 412",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495066",
            "telephone_number": "763-703-3749",
            "fax_number": "763-703-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETTERLUND",
        "first_name": "MELISSA",
        "credential": "MA, LP, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "LMFT 1867",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "LMFT1867",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP 5014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsey Marie Joy Weintraub
• Caroline Nicole Weiss, PSY.D, LP
• Wellness Diabetes Care LLC
• Wellness Health Clinic LLC
• Sara Werner, MA, LP, RPT-S, SEP
• Emmanuel Wheagar II, PHARMD
• Amy Moran Wheelecor, PSYD, LP
• Lisa Marie Wicklund, LMT
• Allison Lynn Wiedemann, OD
• Benjamin Jerome Williams

• Psychologist in Blaine, MN
• Providers in Blaine, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.