FREDERICK MARCUS VICKERY (NPI# 1215443049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215443049 |
| Entity Type | Individual |
| Full Name | FREDERICK MARCUS VICKERY |
| Credential | LPC, LADC |
| Practice Address |
2550 University Ave W Saint Paul MN 55114-1052 |
| Practice Telephone | 9529936200 |
| Practice Fax Number | 9529771802 |
| Mailing Telephone | 9529936200 |
| Mailing Fax Number | 9529771802 |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2019-03-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
304457 | MN | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
02071 | MN | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 800 E 28th St, Minneapolis, MN 554073723 | 6512418730 | |
| 333 Smith Ave N, Saint Paul, MN 551022344 | 6122418730 | |
| 2925 Chicago Ave, Minneapolis, MN 55407 | 6122638511 | |
| 8550 Hudson Blvd N, Lake Elmo, MN 550425500 | 9529936200 |
| Street Address |
2550 UNIVERSITY AVE W |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55114-1052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396747143 | Colleen Rae Caspers | Nurse Practitioner | 2550 University Ave W, Suite 423 South, Saint Paul, MN 55114-1052 | 2005-08-11 |
| 1538707484 | Hannah Weaver | Nutritionist | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2019-12-11 |
| 1881251114 | Miriam Rebecca Koch Gerber | Psychologist | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2019-05-22 |
| 1578036042 | Sarah Lazarewicz | Social Worker | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2019-01-08 |
| 1790222438 | Plastic Surgery Consultants | Plastic Surgery | 2550 University Ave W, Ste 110n, Saint Paul, MN 55114-1052 | 2017-01-19 |
| 1720537350 | Kulule H Kenea | Nurse Practitioner | 2550 University Ave W, Suite 325s, Saint Paul, MN 55114-1052 | 2016-09-23 |
| 1992250187 | Erin Ziolkowski | Dietitian, Registered | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2016-08-17 |
| 1396196655 | Alyssa Greene | Counselor | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2016-06-28 |
| 1194174854 | Accessible Space, Inc. | Respite Care | 2550 University Ave W, Suite 330n, Saint Paul, MN 55114-1052 | 2016-06-03 |
| 1588013247 | Accessible Space, Inc. | Assisted Living Facility | 2550 University Ave W, Suite 330n, Saint Paul, MN 55114-1052 | 2016-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790205698 | Der Yang | Registered Nurse | 2356 University Ave W #220, Saint Paul, MN 55114 | 2017-06-21 |
| 1679949358 | Mallory Haglund | Counselor | 284 West Rocky Lane, Boulder, NV 55114 | 2015-08-17 |
| 1083090880 | Kayla Estenson | Marriage & Family Therapist | 2324 University Ave West, 120, St. Paul, MN 55114 | 2015-08-04 |
| 1184023772 | Preetanjali Thakur | Dentist | 2550 University Avenue West Suite 189s, St Paul, MN 55114 | 2014-08-19 |
| 1023426210 | Melanie Bayer Witthoft | Social Worker | 762 Transfer Road, 21, St. Paul, MN 55114 | 2014-07-31 |
| 1184046518 | Britni Kelley | Marriage & Family Therapist | 821 Raymond Ave Ste 325, Saint Paul, MN 55114 | 2014-01-21 |
| 1205257581 | Arti Kaul | Dentist | 808 Berry St, Apy 126, St Paul, MN 55114 | 2014-01-03 |
| 1588907109 | Jesus M Calvillo | Counselor | 821 Raymond Ave Ste 230, Saint Paul, MN 55114 | 2013-04-02 |
| 1154669414 | Caringhands Home Health Care Inc. | Home Health | 2233 University Ave West, Suite 330, St Paul, MN 55114 | 2013-01-22 |
| 1396021424 | The Avalon Charter School | Local Education Agency (LEA) | 700 Glendale Street, Saint Paul, MN 55114 | 2011-11-03 |
| Find all providers in zip 55114 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053948315 | 61 Experience | Counselor | 1 Water St W Ste 230, Saint Paul, MN 55107-2002 | 2020-03-26 |
| 1003453473 | Elizabeth Subramaniam | Counselor | 658 Grand Ave, Saint Paul, MN 55105-3417 | 2019-12-04 |
| 1689217283 | Laufenberg Consulting Services | Counselor | 1619 Dayton Ave Ste 321, Saint Paul, MN 55104-6276 | 2019-10-26 |
| 1841833423 | Autism Center | Counselor | 1821 University Ave W Ste 219, Saint Paul, MN 55104-2892 | 2019-10-25 |
| 1518523497 | Angela Marie Blesener | Counselor | 1821 University Ave W Ste 385, Saint Paul, MN 55104-2872 | 2019-05-15 |
| 1508339821 | Integrative Wellness Counseling LLC | Counselor | 1619 Dayton Ave Ste 112, Saint Paul, MN 55104-6276 | 2019-01-09 |
| 1598233074 | Veasna Pho | Counselor | 777 Raymond Ave, Saint Paul, MN 55114-1522 | 2018-11-02 |
| 1366925828 | Amy Stoks | Counselor | 493 Selby Ave, Saint Paul, MN 55102-1726 | 2018-09-11 |
| 1396225140 | Anney Lyons | Counselor | 1884 Como Ave, Saint Paul, MN 55108-2715 | 2018-08-20 |
| 1073005120 | Northstar Mental Health Services LLC | Counselor | 1932 University Ave W, Saint Paul, MN 55104-3426 | 2018-06-05 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55114 |
Please comment or provide details below to improve the information on FREDERICK MARCUS VICKERY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.