Odessa Lee Vickery-Merrigan

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW10555 Issued in FL

Practice address

9208 Palos Verde Dr
Orlando, FL 32825-8048

Phone

(407) 415-2094

NPI assigned

Dec 5, 2016

Last updated

Dec 5, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Odessa Lee Vickery Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kinder Konsulting & Parents Too, Inc.

  • Community/Behavioral Health Agency
  • Winter Park, FL
  • NPI 1346353067

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1073057394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9208 PALOS VERDE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328258048",
            "telephone_number": "407-415-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9208 PALOS VERDE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328258048",
            "telephone_number": "407-415-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERY-MERRIGAN",
        "first_name": "ODESSA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-05",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW10555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ODESSA",
            "last_name": "VICKERY",
            "middle_name": "LEE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hamilton Page Vick, MD
• Arlene A Vickers, ARNP
• Donald Crisp Vickers Jr., RPH BCNSP
• Ileana Vickers, APRN
• Michelle Marlo Boucher Vickers, NCC, CRC, LMHC
• Christian Pocholo Vicmudo
• Victor N. Alvarado MD 'LLC'
• Noelle Ruth Victor-Nicolas
• Elaine Victor, BEHAVIORAL TECH
• Adriana Victoria

• Clinical Social Worker in Orlando, FL
• Providers in Orlando, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.