Healthcare Provider Details

I. General information

NPI: 1093095093
Provider Name (Legal Business Name): JESSIKA BETH HIGHERS MA, I-CADC, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA BETH RENUSCH MA, I-CADC, CADC

II. Dates (important events)

Enumeration Date: 08/22/2011
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 MORGAN ST
POOLER GA
31322-2615
US

IV. Provider business mailing address

127 MORGAN ST
POOLER GA
31322-2615
US

V. Phone/Fax

Practice location:
  • Phone: 586-484-6252
  • Fax:
Mailing address:
  • Phone: 586-484-6252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: