Provider Demographics
NPI:1558657221
Name:HIGGS, JUSTIN CODY (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:CODY
Last Name:HIGGS
Suffix:
Gender:M
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 TROTWOOD AVE
Mailing Address - Street 2:SUITE 24
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-3046
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1129 TROTWOOD AVE
Practice Address - Street 2:SUITE 24
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-3046
Practice Address - Country:US
Practice Address - Phone:931-626-3278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3271101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional