Kenneth John Vick, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.003698 Issued in IL

Practice address

10537 S Roberts Rd
Palos Hills, IL 60465-1933

Phone

(708) 974-2300

NPI assigned

Aug 14, 2007

Sex

Male

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

• Mr. Ken J Vick Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1932391984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10537 S ROBERTS RD",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651933",
            "telephone_number": "708-974-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10537 S ROBERTS RD",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651933",
            "telephone_number": "708-974-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICK",
        "first_name": "KENNETH",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.003698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEN",
            "last_name": "VICK",
            "middle_name": "J",
            "prefix": "MR.",
            "credential": "LCPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Professional Counselor in Palos Hills, IL
• Providers in Palos Hills, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.