Provider Demographics
NPI:1407060817
Name:HIGGINS, ELIZABETH WRIGHT (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:WRIGHT
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 STATE ST
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1923
Mailing Address - Country:US
Mailing Address - Phone:207-664-6175
Mailing Address - Fax:207-664-1544
Practice Address - Street 1:85 STATE ST
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1923
Practice Address - Country:US
Practice Address - Phone:207-664-6175
Practice Address - Fax:207-664-1544
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC127481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432560499Medicaid