Individual
MICHAEL VICKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SWT
Contact information
Practice address
1351 NEWTOWN PIKE BLDG 1, LEXINGTON, KY 40511-1277
(859) 253-1686
Mailing address
1351 NEWTOWN PIKE BLDG 1, LEXINGTON, KY 40511-1277
(859) 253-1686
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.2504433-TRNE
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
05/07/2019
Last updated
10/07/2025
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