Vladimir Aleksandrovich Gordeyev, MS, LMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4425 Issued in MN

Practice address

7401 Metro Blvd Ste 250
Edina, MN 55439-3062

Phone

(612) 268-5858

Fax

(612) 268-5868

NPI assigned

Sep 13, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Affinity Psychological Services, P.C.

  • Mental Health Counselor
  • Edina, MN
  • NPI 1245610856
  Medicare reassignment NPD
• Anchor and Bloom Therapy PLLC

  • Mental Health Counselor
  • Blaine, MN
  • NPI 1255278313
  NPD Authorized official

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1609324128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 42ND ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503122701",
            "telephone_number": "515-255-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 METRO BLVD STE 250",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554393062",
            "telephone_number": "612-268-5858",
            "fax_number": "612-268-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDEYEV",
        "first_name": "VLADIMIR",
        "middle_name": "ALEKSANDROVICH",
        "credential": "MS, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-13",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "082182",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4425",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "4425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0469676",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "558566",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4425",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tao Gong, L.AC
• Cristina Marie Gonzalez Mendez, MD
• Miguel Gonzalez, PT
• Katherine Goodman, MSW, LICSW, LADC
• Sheila Rosenthal Goodman, M.D.
• Joseph John Gordon, CRNA
• Kyia Gordon
• Lakesha Gordon, CPT
• Jamie Gore
• Matthew William Gorman, M.D.

• Mental Health Counselor in Edina, MN
• Providers in Edina, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.