Michel George Vangordon, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC36265 Issued in CA

Practice address

3351 Lake Tahoe Blvd Ste 9
South Lake Tahoe, CA 96150-7920

Phone

(530) 318-1502

Fax

(530) 600-3866

NPI assigned

Apr 12, 2007

Last updated

Jan 19, 2017By 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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1649494345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10063",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961583063",
            "telephone_number": "530-318-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 LAKE TAHOE BLVD STE 9",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507920",
            "telephone_number": "530-318-1502",
            "fax_number": "530-600-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANGORDON",
        "first_name": "MICHEL",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC36265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in South Lake Tahoe, CA
• Providers in South Lake Tahoe, 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 Jan 19, 2017; 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.