MEDICARE: MRS. SHELBI VICKERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	PLC9120	LA

General Provider Information

NPI Number	:	1639010200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHELBI VICKERS

Provider Business Mailing Address
First Line	:	28665 LINDSEY ERIN LN
Second Line	:
City	:	ALBANY
State	:	LA
Zip	:	70711-2403
Country	:	US
Telephone Number	:	985-981-7343
Fax Number	:

Provider Business Practice Location Address
First Line	:	28665 LINDSEY ERIN LN
Second Line	:
City	:	ALBANY
State	:	LA
Zip	:	70711-2403
Country	:	US
Telephone Number	:	985-981-7343
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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