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Individual

JESICA G. VICKERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, LIMHP, PLADC

Contact information

Practice address
125 E 31ST ST, KEARNEY, NE 68847-3001
(308) 234-6029
Mailing address
3 WILLOW LN, KEARNEY, NE 68845-4880
(308) 920-0984

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
P-1114
NE
101YM0800X
Mental Health Counselor
Primary
1261
NE
101YM0800X
Mental Health Counselor
4255
NE

Other

Enumeration date
06/14/2011
Last updated
07/14/2015
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