Kurt Steven Vaillancourt, LMFT

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

MFC37679 Issued in CA

Practice address

9201 W Sunset Blvd
Suite 718
West Hollywood, CA 90069-3701

Phone

(310) 991-5878

Fax

(866) 352-1072

NPI assigned

Sep 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386743078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 DE LONGPRE AVE.",
            "address_2": "APT. #22",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900463977",
            "telephone_number": "310-991-5878",
            "fax_number": "866-352-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 W SUNSET BLVD",
            "address_2": "SUITE 718",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900693701",
            "telephone_number": "310-991-5878",
            "fax_number": "866-352-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAILLANCOURT",
        "first_name": "KURT",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "MFC37679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in West Hollywood, CA
• Providers in West Hollywood, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.