Lyndon L. Blodgett, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 39810 Issued in CA

Practice address

2431 W March LN Ste 200
Stockton, CA 95207-8211

Phone

(209) 915-4748

NPI assigned

Apr 3, 2007

Last updated

Mar 9, 2021By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Alpine Christian Counseling Associates, Inc

  dba Alpine Counseling Center

  • Marriage & Family Therapist
  • Stockton, CA
  • NPI 1659315547
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1649391848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10428 RUBICON AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952197113",
            "telephone_number": "209-915-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 W MARCH LN STE 200",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952078211",
            "telephone_number": "209-915-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLODGETT",
        "first_name": "LYNDON",
        "middle_name": "L.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 39810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A-05-679",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "MFT398100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Bliatout, MD
• Silke Blietschau
• John F Blinn III, MD
• Victoria Mary Blizzard, M.D.
• Nicole Monique Block
• Grant A Blon Jr., CMPSS
• Joanne Marie Blount, PPS, LEP
• Leshonna Blueford
• Bluepoint Pharmacy Inc
• Leanne Fei Blum

• Marriage & Family Therapist in Stockton, CA
• Providers in Stockton, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.