Provider Demographics
NPI:1366127060
Name:VICKERS, LINDSEY PAIGE FETTY (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:PAIGE FETTY
Last Name:VICKERS
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 FIRWOOD S
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-5597
Mailing Address - Country:US
Mailing Address - Phone:512-694-3677
Mailing Address - Fax:
Practice Address - Street 1:124 SUNRISE DR
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-9735
Practice Address - Country:US
Practice Address - Phone:512-694-3677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health