Provider Demographics
NPI:1851545925
Name:HIGDON, TIM (MS, LPC)
Entity Type:Individual
Prefix:
First Name:TIM
Middle Name:
Last Name:HIGDON
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 NW GREELEY AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-2913
Mailing Address - Country:US
Mailing Address - Phone:541-330-9782
Mailing Address - Fax:541-317-9757
Practice Address - Street 1:115 NW GREELEY AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-2913
Practice Address - Country:US
Practice Address - Phone:541-330-9782
Practice Address - Fax:541-317-9757
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-15
Last Update Date:2008-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1042101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional