1114038817 NPI number — PROF. DANIEL HIGGINS LPCC

Table of content: PROF. DANIEL HIGGINS LPCC (NPI 1114038817)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114038817 NPI number — PROF. DANIEL HIGGINS LPCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HIGGINS
Provider First Name:
DANIEL
Provider Middle Name:
Provider Name Prefix Text:
PROF.
Provider Name Suffix Text:
Provider Credential Text:
LPCC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114038817
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
791 FLAT ROCK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLEVUE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44811-9410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-484-0603
Provider Business Mailing Address Fax Number:
419-483-9247

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
817 KILBOURNE ST
Provider Second Line Business Practice Location Address:
SUITE G
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44811-9431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-483-9411
Provider Business Practice Location Address Fax Number:
419-483-9247
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  E3595 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 103TP2701X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000140737 . This is a "ANTHEM BC &BS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 7275114 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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