Provider Demographics
NPI:1205926557
Name:HIGGINS, ALICE D (PHD)
Entity type:Individual
Prefix:DR
First Name:ALICE
Middle Name:D
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WEBB RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-2615
Mailing Address - Country:US
Mailing Address - Phone:203-744-4228
Mailing Address - Fax:203-748-6343
Practice Address - Street 1:3 WEBB RD
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-2615
Practice Address - Country:US
Practice Address - Phone:203-744-4228
Practice Address - Fax:203-748-6343
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1260103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060001260CT01OtherANTHEM BLUE CROSS
CTZS095OtherOXFORD HEALTH PLANS
CT037991OtherMHN
CT037991OtherMHN