Provider Demographics
NPI:1750856050
Name:HIGGINSON, LISA MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:HIGGINSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:DODGION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1525 S HIGLEY RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-4795
Mailing Address - Country:US
Mailing Address - Phone:480-702-1135
Mailing Address - Fax:
Practice Address - Street 1:1425 W ELLIOT RD STE 201
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5142
Practice Address - Country:US
Practice Address - Phone:480-223-0223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist