Provider Demographics
NPI:1396825360
Name:HIGGINS, SUZANNE (LCADC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 N CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08609-1011
Mailing Address - Country:US
Mailing Address - Phone:609-396-4557
Mailing Address - Fax:609-396-5938
Practice Address - Street 1:39 N CLINTON AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08609-1011
Practice Address - Country:US
Practice Address - Phone:609-396-4557
Practice Address - Fax:609-396-5938
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00149400101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)