Provider Demographics
NPI:1982114161
Name:HIGGINS, COURTNEY (LMSW)
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 NEW BRITAIN RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06037-1395
Mailing Address - Country:US
Mailing Address - Phone:860-756-0455
Mailing Address - Fax:
Practice Address - Street 1:279 NEW BRITAIN RD STE A
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06037-3165
Practice Address - Country:US
Practice Address - Phone:860-756-0455
Practice Address - Fax:866-469-7058
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3993104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker