Provider Demographics
NPI:1336818731
Name:HIGGINS, AMBER L (LCSW)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:L
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-0316
Mailing Address - Country:US
Mailing Address - Phone:508-862-2639
Mailing Address - Fax:
Practice Address - Street 1:11 STEPENSHELL RD
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-3017
Practice Address - Country:US
Practice Address - Phone:508-776-9171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2201071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA220107OtherMASSHEALTH
MA220107OtherLCSW