BLOSSOMING MINDS PSYCHOLOGICAL SERVICES, LLC
NPI 1649037730
Psychologist in Fishers, IN

Active since March 05, 2024
14074 TRADE CENTER DR STE 208, FISHERS, IN 46038(317) 967-4099 Get Directions Write a Review

NPPES record last updated: March 5, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Blossoming Minds Psychological Services, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLOSSOMING MINDS PSYCHOLOGICAL SERVICES, LLC (NPI 1649037730) is a healthcare organization registered as a psychologist in Fishers, Indiana and active in the NPI registry since March 2024. The organization lists Christine Marie Liedtke, Owner, as its authorized official.

NPPES Registry Identity

NPI1649037730
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameBLOSSOMING MINDS PSYCHOLOGICAL SERVICES, LLC
Location Address14074 TRADE CENTER DR STE 208Fishers, IN 46038-4574
Mailing Address14074 Trade Center Dr Ste 208Fishers, IN 46038-4574 · (317) 967-4099
Organization SubpartNo
Authorized OfficialChristine Marie LiedtkeOwner · (317) 967-4099
Enumeration DateMarch 5, 2024
NPPES CertifiedMarch 5, 2024
✔ NPI 1649037730 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
14074 TRADE CENTER DR STE 208, Fishers, IN 46038

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Blossoming Minds Psychological Services, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Blossoming Minds Psychological Services, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Psychologist Billing Independently
NPI 1801196282
14074 TRADE CENTER DR STE 208
Fishers, IN 46038
(440) 241-5275
Same address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blossoming Minds Psychological Services, LLC's NPI number?

The NPI number for Blossoming Minds Psychological Services, LLC is 1649037730. It was assigned to this organization in the NPPES registry on March 5, 2024.

Where is Blossoming Minds Psychological Services, LLC located?

Blossoming Minds Psychological Services, LLC is located at 14074 Trade Center Dr Ste 208, Fishers, IN 46038. The listed phone number is (317) 967-4099.

What is Blossoming Minds Psychological Services, LLC's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Blossoming Minds Psychological Services, LLC enrolled in Medicare?

Yes. Blossoming Minds Psychological Services, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Blossoming Minds Psychological Services, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Psychologist Billing Independently) reassigns their Medicare billing to Blossoming Minds Psychological Services, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Blossoming Minds Psychological Services, LLC was last updated on March 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.