Provider Demographics
NPI:1285196055
Name:HIGGINS, WENDY SUZETTE (LPC CSAC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:SUZETTE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:LPC CSAC
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:SUZETTE
Other - Last Name:BOLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSAC
Mailing Address - Street 1:241 GREENHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-3717
Mailing Address - Country:US
Mailing Address - Phone:540-463-3141
Mailing Address - Fax:540-462-6705
Practice Address - Street 1:241 GREENHOUSE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-3717
Practice Address - Country:US
Practice Address - Phone:540-463-3141
Practice Address - Fax:540-462-6705
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710102349101YA0400X
VA0701007818101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)