Blue Thistle Psychotherapy, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

BLUE THISTLE PSYCHOTHERAPY, LLC

Practice address

1409 Willow St Ste 609
Minneapolis, MN 55403-3283

Phone

(651) 212-5205

Fax

(612) 206-9077

NPI assigned

Feb 15, 2024

Last updated

Feb 24, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Josette Wynne, MSWNPI 1194486951

Title

Owner/Sole Member

Phone

(612) 578-7916

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Josette C Wynne, LICSW

  • Clinical Social Worker
  • Eagan, MN
  • NPI 1194486951
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1760247068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 WILLOW ST STE 609",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033283",
            "telephone_number": "651-212-5205",
            "fax_number": "612-206-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 WILLOW ST STE 609",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033283",
            "telephone_number": "651-212-5205",
            "fax_number": "612-206-9077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11525 River Hills Dr",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553373215",
            "country_code": "US",
            "telephone_number": "161-257-8791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUE THISTLE PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-15",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "WYNNE",
        "authorized_official_first_name": "JOSETTE",
        "authorized_official_title_or_position": "OWNER/SOLE MEMBER",
        "authorized_official_telephone_number": "612-578-7916",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Adult Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.