# FULL SPECTRUM PSYCHOTHERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285802066
- **Authorized official:** GRETCHEN LEE BUEIDE MA, LPC, CEAP (OWNER)
- **Authorized official phone:** (952) 544-2288

## Contact information

- **Practice address:** 7515 WAYZATA BLVD, SUITE 211, ST LOUIS PARK, MN 55426-1604
- **Practice address phone:** (952) 544-2288
- **Mailing address:** 7515 WAYZATA BLVD, SUITE 211, ST LOUIS PARK, MN 55426-1604
- **Mailing address phone:** (952) 544-2288

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 00036 | MN | Yes |

## Other

- **Enumeration date:** 02/14/2008
- **Last updated:** 02/14/2008