Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

FREDERICK MARCUS VICKERY LPPC, LADC
NPI 1215443049
Counselor - Professional in St Louis Park, MN

Active since December 15, 2017PECOS Enrolled
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426(952) 993-5000 Get Directions Write a Review

NPPES record last updated: September 4, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Sep 4, 2026, Sep 9, 2025, Mar 20, 2019 and 2 more (5 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 professional provider in St Louis Park, Minnesota, licensed in Minnesota (1835) and active in the NPI registry since December 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215443049
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameFREDERICK MARCUS VICKERYCredential: LPPC, LADC
Location Address6500 EXCELSIOR BLVDSt Louis Park, MN 55426-4702
Mailing Address8170 33rd Avenue, Mailstop 21110qBloomington, MN 55425-4516
Sole ProprietorNo
Enumeration DateDecember 15, 2017
Last NPPES UpdateSeptember 4, 20265 updates tracked since enumeration
NPPES CertifiedSeptember 4, 2026
NPI 1215443049 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in MN · 1835
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 304457 (MN)
6500 EXCELSIOR BLVD, St Louis Park, MN 55426

Accepted 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.

Obstetrics & Gynecology
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Obstetrics & Gynecology
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Internal Medicine
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Internal Medicine
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Internal Medicine (Cardiovascular Disease)
6500 EXCELSIOR BLVD, PARK NICOLLET CLINIC - HEART & VASCULAR CENTER
ST LOUIS PARK, MN 55426
Occupational Therapist
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Physical Therapist
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426
Physical Therapist
6500 EXCELSIOR BLVD
ST LOUIS PARK, MN 55426

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 6500 Excelsior Blvd, St Louis Park, MN 55426. The listed phone number is (952) 993-5000.

What is Frederick Vickery's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

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 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 days 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.