Provider Demographics
NPI:1629051859
Name:HIGLEY, SARAH J (PSYD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:J
Last Name:HIGLEY
Suffix:
Gender:F
Credentials:PSYD
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 1282
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46527-1282
Mailing Address - Country:US
Mailing Address - Phone:574-213-2061
Mailing Address - Fax:
Practice Address - Street 1:109 E CLINTON ST STE 15
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46528-3233
Practice Address - Country:US
Practice Address - Phone:574-213-2061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041947A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200800480Medicaid
INQ55076Medicare UPIN
IN657050KMedicare PIN