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General NPI Number Information
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NPI Number | 1952277287
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Entity Type | Individual
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Provider Name | LAVERNA S VICKERS
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Gender | Female
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 400 E STATE ST STE D
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City | ATHENS
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State | OH
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Zip | 45701-1870
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Country | US
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Telephone | 740-249-4514
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Fax | 800-480-7578
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Provider Business Mailing Address
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Address Line | PO BOX 212
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City | COTTAGEVILLE
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State | WV
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Zip | 25239-0212
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Country | US
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Telephone | 304-412-2578
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Fax |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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