Melissa Anderson Polusny, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP4362 Issued in MN

Practice address

3490 Lythrum Way
Minnetrista, MN 55364-9438

Phone

(942) 214-2858

NPI assigned

Jul 30, 2006

Last updated

Jan 12, 2026By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1669487229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 LYTHRUM WAY",
            "city": "MINNETRISTA",
            "state": "MN",
            "postal_code": "553649438",
            "telephone_number": "952-214-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 LYTHRUM WAY",
            "city": "MINNETRISTA",
            "state": "MN",
            "postal_code": "553649438",
            "telephone_number": "942-214-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLUSNY",
        "first_name": "MELISSA",
        "middle_name": "ANDERSON",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa McCartney, NP
• Janel R Miller, MOT OTRL
• Amanda S Myers, MS, CCC-SLP
• Kristin Ann Palesch, M.A.
• Anne Pierce, RN, CNP
• Saba Ghazimoghadam, PH.D., LP, LLC
• Thriver Health
• We Care Transportation Inc
• Westonka Public Schools
• Derek Young

• Clinical Psychologist in Minnetrista, MN
• Providers in Minnetrista, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; 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.