Individual
FREDERICK MARCUS VICKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPPC, LADC
Contact information
Practice address
621 W LAKE ST STE 350, MINNEAPOLIS, MN 55408-2952
(651) 895-7887
Mailing address
621 W LAKE ST STE 350, MINNEAPOLIS, MN 55408-2952
(651) 895-7887
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304457
MN
101YP2500X
Professional Counselor
1835
MN
Other
Enumeration date
12/15/2017
Last updated
09/09/2025
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