Organization · Type 2 NPI

Blue Iris Therapy, PLLC

Community/Behavioral Health Agency · Richfield, MN

NPI number 1649564188 Active

Practice location

6437 Lyndale Ave S, Suite 101
Richfield, MN 55423-1465

Fax (612) 455-4041

Specialties and licenses

Taxonomy	Code	License
Community/Behavioral Health Agency Primary	251S00000X	943 (MN)

Community/Behavioral Health Agency: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day suppo…

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NPI record

NPI: 1649564188
Entity type: Organization (Type 2)
Issued: Jun 1, 2011
Last updated: Jun 1, 2011
Status: Active

Other names

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Blue Iris Center for Therapeutic Services, LLC · former legal business name

Authorized official

Dr. Grant D Chikazawa-Nelson, PhD
Owner/psychotherapist
(612) 655-9776

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About NPI 1649564188

Blue Iris Therapy, PLLC's National Provider Identifier is 1649564188, issued on Jun 1, 2011. The primary taxonomy on file is Community/Behavioral Health Agency (251S00000X), and the practice location is in Richfield, MN. The record was last updated on Jun 1, 2011.