Provider Demographics
NPI:1639484389
Name:HIGGINS, RYAN JOSEPH (LCPC)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:JOSEPH
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SALT CREEK LN STE 202
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-2903
Mailing Address - Country:US
Mailing Address - Phone:331-221-2505
Mailing Address - Fax:312-360-1984
Practice Address - Street 1:8 SALT CREEK LN STE 202
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-2903
Practice Address - Country:US
Practice Address - Phone:331-221-2505
Practice Address - Fax:312-360-1984
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007557101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180007557OtherSTATE LICENSE