The Blue Lotus, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

THE BLUE LOTUS, LLC

Practice address

225 W Cavour Ave Ste C
Fergus Falls, MN 56537-2140

Phone

(218) 770-0593

NPI assigned

Apr 1, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Christianne M Lysne, PH.D.NPI 1316158439

Title

Owner

Phone

(218) 770-0593

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

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

• Christianne M Lysne, PHD

  • Clinical Psychologist
  • Fergus Falls, MN
  • NPI 1316158439
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1760944615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31255 153RD AVE",
            "city": "ELIZABETH",
            "state": "MN",
            "postal_code": "565339562",
            "telephone_number": "218-770-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W CAVOUR AVE STE C",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372140",
            "telephone_number": "218-770-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BLUE LOTUS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "LYSNE",
        "authorized_official_first_name": "CHRISTIANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-770-0593",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron John Teigen, DPT
• Maria Ann Teigland, REGISTERED NURSE
• Jodi Larae Tenneson, LPN
• Natalie Briann Terhaar
• The Birth Nest - Midwifery & Birth Center, LLC
• Joan Marilyn Thole
• Steven B Thom, MD
• Kristi Thoma, OTR/L
• John Martin Thomas, MD
• Jayson Thompson, PHARM.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Fergus Falls, MN
• Providers in Fergus Falls, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.