Individual
ANTHONY JEROME VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED, NCC, ST
Contact information
Practice address
3950 COBB PKWY NW STE 501, ACWORTH, GA 30101-9529
(770) 616-1706
Mailing address
5756 LAKE CT NW, KENNESAW, GA 30152-3767
(770) 616-1706
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
015665
GA
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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