Provider Demographics
NPI:1134317670
Name:HIGINBOTHAM, RICHARD D (MSW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:D
Last Name:HIGINBOTHAM
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 N FLAGLER DR APT 201
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-4442
Mailing Address - Country:US
Mailing Address - Phone:734-320-6940
Mailing Address - Fax:561-844-6602
Practice Address - Street 1:3940 N FLAGLER DR APT 201
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-4442
Practice Address - Country:US
Practice Address - Phone:734-320-6940
Practice Address - Fax:561-844-6602
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW87691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical