Healthcare Provider Details

I. General information

NPI: 1861930141
Provider Name (Legal Business Name): ELIZABETH M HIGGINS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2017
Last Update Date: 11/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15814 E 24 HWY
INDEPENDENCE MO
64050-2015
US

IV. Provider business mailing address

2401 GILLHAM RD
KANSAS CITY MO
64108-4619
US

V. Phone/Fax

Practice location:
  • Phone: 816-753-1881
  • Fax:
Mailing address:
  • Phone: 816-234-3000
  • Fax: 816-302-9939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2017002040
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: