Vickers, Jessica Ann

Vickers, Jessica Ann is an sole proprietor health care provider with primary practice located at 145 E Main St , Elkton MD 21921-5917. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Vickers, Jessica Ann can be contacted via phone (443) 203-9850.

Contact Information

Primary practice address
145 E Main St Elkton MD 21921-5917
Phone: (443) 203-9850
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LC14779 Maryland
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LCA3253 Maryland

Profile Details

NPI number 1609223734
LBN Legal business name Vickers, Jessica Ann
Credentials LCPC, LCADC
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 18th, 2016
Last updated Nov 29th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609223734 NPPES
Maryland MEDICAID 520202700
Maryland MEDICAID 317849800

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