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FREDERICK MARCUS VICKERY LPPC, LADC
NPI 1215443049
Counselor - Addiction (Substance Use Disorder) in Minneapolis, MN

Active since December 15, 2017PECOS Enrolled
621 W LAKE ST STE 350, MINNEAPOLIS, MN 55408(651) 895-7887 Get Directions Write a Review

NPPES record last updated: September 9, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 9, 2025, Mar 20, 2019, Mar 17, 2018 and 1 more (4 updates tracked since 2017).

About Frederick Marcus Vickery Lppc, Ladc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FREDERICK MARCUS VICKERY LPPC, LADC (NPI 1215443049) is an individual addiction (substance use disorder) provider in Minneapolis, Minnesota, licensed in Minnesota (304457) and active in the NPI registry since December 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215443049
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameFREDERICK MARCUS VICKERYCredential: LPPC, LADC
Location Address621 W LAKE ST STE 350Minneapolis, MN 55408-2952
Mailing Address621 W Lake St Ste 350Minneapolis, MN 55408-2952 · (651) 895-7887
Phone(651) 895-7887
Sole ProprietorNo
Enumeration DateDecember 15, 2017
Last NPPES UpdateSeptember 9, 20254 updates tracked since enumeration
NPPES CertifiedSeptember 9, 2025
✔ NPI 1215443049 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in MN · 304457
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 1835 (MN)
621 W LAKE ST STE 350, Minneapolis, MN 55408
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Frederick Marcus Vickery Lppc, Ladc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LISA HOLLIDAY LICSW
Social Worker (Clinical)
621 W LAKE ST STE 350
MINNEAPOLIS, MN 55408
Hennepin County (612) 888-5305
CHERYL M TROXEL LMFT
Marriage & Family Therapist
621 W LAKE ST STE 350
MINNEAPOLIS, MN 55408
Hennepin County (612) 547-9990
CHARLOTTE MORGAN MSW, LICSW
Social Worker (Clinical)
621 W LAKE ST STE 350
MINNEAPOLIS, MN 55408
Hennepin County (612) 979-2276
AMY BEADLE
Counselor (Mental Health)
621 W LAKE ST STE 350
MINNEAPOLIS, MN 55408
Hennepin County (612) 979-2276
ERIKA KEATON
Counselor (Mental Health)
621 W LAKE ST STE 350
MINNEAPOLIS, MN 55408
Hennepin County (612) 979-2276
JENNA MCDOUGALL R.D.N., L.D.
Dietitian, Registered
621 W LAKE ST STE 350
MINNEAPOLIS, MN 55408
Hennepin County (651) 983-4391
TARA LEBARON LPCC
Counselor (Mental Health)
621 W LAKE ST STE 350
MINNEAPOLIS, MN 55408
Hennepin County (612) 979-2276
JEAN RIVARD LICSW
Social Worker (Clinical)
621 W LAKE ST STE 350
MINNEAPOLIS, MN 55408
Hennepin County (612) 979-2276

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Frederick Vickery's NPI number?

The NPI number for Frederick Vickery is 1215443049. It was assigned to this individual provider in the NPPES registry on December 15, 2017.

Where is Frederick Vickery located?

Frederick Vickery practices at 621 W Lake St Ste 350, Minneapolis, MN 55408. The listed phone number is (651) 895-7887.

What is Frederick Vickery's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Frederick Vickery enrolled in Medicare?

Yes. Frederick Vickery is registered in the Medicare PECOS enrollment system.

What insurance does Frederick Vickery accept?

Health plans from HealthPartners list Frederick Vickery as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Frederick Vickery was last updated on September 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.