Active NPI
Randall Steven Vickers, M.S.
- Mental Health Counselor
- Tallahassee, FL
National Provider Identifier
1033412820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH 770
- Practice address
- 565 E Tennessee St
Tallahassee, FL 32308-4981 - Phone
- (850) 681-6543
- NPI assigned
- Dec 16, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH 770 | FL | Primary |
Addresses
Primary practice location
565 E Tennessee St
Tallahassee, FL 32308-4981
Mailing address
565 E Tennessee St
Tallahassee, FL 32308-4981
Phone (850) 681-6543
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH 770 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292457600000",
"number": "1033412820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "565 E TENNESSEE ST",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323084981",
"telephone_number": "850-681-6543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "565 E TENNESSEE ST",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323084981",
"telephone_number": "850-681-6543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICKERS",
"first_name": "RANDALL",
"middle_name": "STEVEN",
"name_prefix": "Mr.",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-12-16",
"last_updated": "2010-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH 770",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.