Provider Demographics
NPI:1003218942
Name:ACACIA COUNSELING & WELLNESS
Entity Type:Organization
Organization Name:ACACIA COUNSELING & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HARLAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:HIGGINBOTHAM
Authorized Official - Suffix:JR
Authorized Official - Credentials:PSYD
Authorized Official - Phone:805-364-2482
Mailing Address - Street 1:PO BOX 30910
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93130-0910
Mailing Address - Country:US
Mailing Address - Phone:805-364-2482
Mailing Address - Fax:
Practice Address - Street 1:6586 PICASSO RD
Practice Address - Street 2:
Practice Address - City:ISLA VISTA
Practice Address - State:CA
Practice Address - Zip Code:93117-4651
Practice Address - Country:US
Practice Address - Phone:805-699-6668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26572103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty