Provider Demographics
NPI:1336358597
Name:HIGGINS, LYNN B (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:B
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LYNN
Other - Middle Name:B
Other - Last Name:HIGGINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:15 TOWNSEND ST
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-1306
Mailing Address - Country:US
Mailing Address - Phone:516-759-5675
Mailing Address - Fax:516-759-5289
Practice Address - Street 1:15 GLEN ST
Practice Address - Street 2:SUITE 302
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2782
Practice Address - Country:US
Practice Address - Phone:516-759-5675
Practice Address - Fax:516-759-5289
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
102L00000X
NYR040347-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical