Provider Demographics
NPI:1942207873
Name:SAVAGE-HIGGENBOTTOM, BETH (ACSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:
Last Name:SAVAGE-HIGGENBOTTOM
Suffix:
Gender:F
Credentials:ACSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 LAKE PLAZA DR
Mailing Address - Street 2:SUITE A-106
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-4061
Mailing Address - Country:US
Mailing Address - Phone:317-845-0266
Mailing Address - Fax:317-845-9255
Practice Address - Street 1:6801 LAKE PLAZA DR
Practice Address - Street 2:SUITE A-106
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4061
Practice Address - Country:US
Practice Address - Phone:317-845-0266
Practice Address - Fax:317-845-9255
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ININ34000002421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN339710Medicare ID - Type UnspecifiedSOCIAL WORKER