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General NPI Number Information
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NPI Number | 1609324128
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Entity Type | Individual
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Provider Name | VLADIMIR ALEKSANDROVICH GORDEYEV MS, LMFT
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Gender | Male
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 7401 METRO BLVD STE 250
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City | EDINA
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State | MN
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Zip | 55439-3062
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Country | US
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Telephone | 612-268-5858
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Fax | 612-268-5868
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Provider Business Mailing Address
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Address Line | 600 42ND ST
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City | DES MOINES
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State | IA
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Zip | 50312-2701
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Country | US
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Telephone | 515-255-8399
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 082182
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4425
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4425
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License Number State | MN
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