Anthony Jerome Vickers, M.ED, NCC, ST

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

015665 Issued in GA

Practice address

3950 Cobb Pkwy NW Ste 501
Acworth, GA 30101-9529

Phone

(770) 616-1706

NPI assigned

Apr 7, 2025

Last updated

Apr 7, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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.

• Tranquil Life Counseling Center, LLC

  • Professional Counselor
  • Hiram, GA
  • NPI 1538671581

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1588458285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5756 LAKE CT NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523767",
            "telephone_number": "770-616-1706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 COBB PKWY NW STE 501",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301019529",
            "telephone_number": "770-616-1706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "ANTHONY",
        "middle_name": "JEROME",
        "credential": "M.ED, NCC, ST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "015665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee Michelle Vanfosssen
• Bhavana Venugopalan, D.M.D.
• Anit S Vettukattil, MD
• Vibrant Health Center, LLC (Marisa Mikals, DC)
• Natasha Vicente, RN
• Village Podiatry Group, LLC.
• Laura M Vincent, PT
• Stephen John Vinoba, MD
• Vision One Inc
• Vision Onsite

• Mental Health Counselor in Acworth, GA
• Providers in Acworth, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.