Provider Demographics
NPI:1033182001
Name:FARRELL-HIGGINS, JONATHAN M (PHD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:M
Last Name:FARRELL-HIGGINS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3649 SW BURLINGAME RD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-2051
Mailing Address - Country:US
Mailing Address - Phone:785-266-6751
Mailing Address - Fax:785-266-4533
Practice Address - Street 1:3649 SW BURLINGAME RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-2051
Practice Address - Country:US
Practice Address - Phone:785-266-6751
Practice Address - Fax:785-266-4533
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS740103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS6146450OtherUNITED BEHAVIORAL HEALTH
KS6146450OtherUNITED BEHAVIORAL HEALTH