Provider Demographics
NPI:1700877511
Name:DELP HIGGINS, KATHEEN (LMSW, CGC)
Entity Type:Individual
Prefix:MS
First Name:KATHEEN
Middle Name:
Last Name:DELP HIGGINS
Suffix:
Gender:F
Credentials:LMSW, CGC
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:J
Other - Last Name:DELP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW,CGC
Mailing Address - Street 1:100 MICHIGAN ST NE # MC845
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25 MICHIGAN ST NE STE 2000
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2526
Practice Address - Country:US
Practice Address - Phone:616-391-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-01
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010590361041C0700X
MI7201000185170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P03050OtherMEDICARE PROVIDER NUMBER
MI0P03050Medicare ID - Type Unspecified