Melissa Anderson Polusny, PHD
Individual provider Active NPI Clinical Psychologist · Minnetrista, MN
NPI 1669487229 · NPPES record last updated Jan 12, 2026
Key facts
- NPI
- 1669487229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- LP4362 (MN)
- Practice address
- 3490 Lythrum Way
Minnetrista, MN 55364-9438 - Phone
- (942) 214-2858
- NPI assigned
- Jul 30, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP4362 | MN | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP4362 | MN | Yes |
Addresses
Primary practice location
3490 Lythrum Way
Minnetrista, MN 55364-9438
Mailing address
3490 Lythrum Way
Minnetrista, MN 55364-9438
Phone (952) 214-2858
Other providers in Minnetrista, MN
- Elizabeth Victoria Lewis
- Janel R Miller
- Amanda S Myers
- Kristin Ann Palesch
- Anne Pierce
- Saba Ghazimoghadam, PH.D., LP, LLC
- Thriver Health
- We Care Transportation Inc
- Westonka Public Schools
- Derek Young
All providers in Minnetrista, MN · Clinical Psychologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.