Provider Demographics
NPI:1467039206
Name:HIGGS, LORI ELLEN (LMHC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ELLEN
Last Name:HIGGS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 W 28TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-2115
Mailing Address - Country:US
Mailing Address - Phone:360-977-7600
Mailing Address - Fax:
Practice Address - Street 1:122 NE DALLAS ST
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-1642
Practice Address - Country:US
Practice Address - Phone:360-977-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61014263101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health