Individual
VLADIMIR ALEKSANDROVICH GORDEYEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LMFT
Contact information
Practice address
7401 METRO BLVD STE 250, EDINA, MN 55439-3062
(612) 268-5858
(612) 268-5868
Mailing address
600 42ND ST, DES MOINES, IA 50312-2701
(515) 255-8399
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
082182
IA
101YM0800X
Mental Health Counselor
Primary
4425
MN
106H00000X
Marriage & Family Therapist
4425
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0469676
—
IA
01
—
4425
STATE LICENSE
MN
01
—
558566
MEDICAID
—
Enumeration date
09/13/2016
Last updated
11/21/2024
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