Provider Demographics
NPI:1619080959
Name:HIGGINS, MILLICENT ALLYN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:MILLICENT
Middle Name:ALLYN
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MISS
Other - First Name:MILLICENT
Other - Middle Name:ALLYN
Other - Last Name:EIFLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 669
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:VT
Mailing Address - Zip Code:05055-0669
Mailing Address - Country:US
Mailing Address - Phone:802-295-7249
Mailing Address - Fax:802-649-2606
Practice Address - Street 1:205 BILLINGS FARM RD
Practice Address - Street 2:
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001-5400
Practice Address - Country:US
Practice Address - Phone:802-295-7249
Practice Address - Fax:802-649-2606
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-00001461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical