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General NPI Number Information
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NPI Number | 1619848553
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Entity Type | Individual
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Provider Name | RACHEL VICKERY LPCC
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Gender | Female
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 5125 COUNTY ROAD 101 STE 300
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City | MINNETONKA
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State | MN
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Zip | 55345-4157
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Country | US
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Telephone | 952-932-7277
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Fax | 952-932-9827
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Provider Business Mailing Address
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Address Line | 14147 DEARBORN PATH
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City | ROSEMOUNT
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State | MN
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Zip | 55068-5044
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Country | US
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Telephone | 952-932-7277
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Fax | 952-932-9827
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 05192
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License Number State | MN
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